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General NPI Number Information
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NPI Number | 1861463788
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Entity Type | Individual
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Provider Name | ROBERT LANCE JOHANSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2006
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Last Update Date | 09/24/2025
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Provider Practice Location Address
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Address Line | 2781 CT SWITZER SENIOR DRIVE SUITE 301
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City | BILOXI
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State | MS
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Zip | 39531-4536
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Country | US
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Telephone | 228-328-2400
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Fax | 228-328-4200
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Provider Business Mailing Address
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Address Line | 2781 CT SWIZTER SR DR SUITE 310
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City | BILOXI
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State | MS
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Zip | 39531-4535
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Country | US
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Telephone | 228-328-2400
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Fax | 228-328-4200
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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 | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 14698
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License Number State | MS
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