IndividualActive
Eddie Johnson, M.D.
NPI 1962738500 · General Practice Physician · Shreveport, LA
Provider details
- NPI number
- 1962738500
- Entity type
- Individual
- Primary specialty
- General Practice PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 013312 (LA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
7330 Fern Ave Ste 1103
Shreveport, LA 71105-4989
Phone: (318) 798-0635
Approximate (ZIP-level) locationGet directions
Mailing address
107 Grayson Cir
Bossier City, LA 71112-8605
Registry dates
- Enumerated
- 2009-11-01
- Last updated
- 2009-11-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.