MR. David Shane Johnson, PA-C

NPI #1962619932 in Magee, Mississippi

Provider Information

NPI Number: 1962619932
Entity Type: Individual
Name: MR. David Shane Johnson, PA-C
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: May 17, 2007
Last Updated: Dec 23, 2019

Practice Location

Address: 376A SIMPSON HIGHWAY 149
City: Magee
State: Mississippi
ZIP Code: 39111-3409
Phone: (601) 849-1475

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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