| Doctor Name: | GLENDA JOHNSON |
| NPI Number: | 1679576243 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 14496R |
| Business Practice Address: | 2400 Hospital Dr Suite 240 Bossier City, LA - 711112385 |
| Business Phone Number: | 3187425800 |
| Business Fax Number: | 3187413902 |
| Mailing Address: | 2400 Hospital Dr, Suite 240 BOSSIER CITY |
| State: | LA |
| Postal Code: | 711112385 |
| Phone Number: | 3187425800 |
| Fax Number: | 3187413902 |
| NPI Enumeration Date: | 05/27/2005 |
| NPI Last Update Date: | 12/21/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/17/2006 |
| NPI Reactivation Date: | 04/25/2006 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207V00000X |
| License Number: | 14496R |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |