Healthcare Provider Details

I. General information

NPI: 1477203339
Provider Name (Legal Business Name): CATHERINE ANN JOHNSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 RUE DE LA VIE ST STE 100
BATON ROUGE LA
70817-5128
US

IV. Provider business mailing address

500 RUE DE LA VIE ST STE 100
BATON ROUGE LA
70817-5128
US

V. Phone/Fax

Practice location:
  • Phone: 512-963-4796
  • Fax:
Mailing address:
  • Phone: 512-963-4796
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number350906
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: