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General NPI Number Information
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NPI Number | 1619081346
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Entity Type | Individual
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Provider Name | RICHARD SCOTT JOHNSON MD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 215 MARION AVE
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City | MCCOMB
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State | MS
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Zip | 39648-2705
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Country | US
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Telephone | 601-249-1382
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Fax | 601-249-1751
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Provider Business Mailing Address
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Address Line | PO BOX 490
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City | MCCOMB
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State | MS
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Zip | 39649-0490
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Country | US
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Telephone | 769-231-7371
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Fax | 601-250-4367
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 18112
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License Number State | MS
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