Provider Demographics
NPI:1275522328
Name:JOHNSON, FRANKLIN R JR (MD)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:R
Last Name:JOHNSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10154 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2725
Mailing Address - Country:US
Mailing Address - Phone:225-927-5663
Mailing Address - Fax:225-928-7341
Practice Address - Street 1:10154 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2725
Practice Address - Country:US
Practice Address - Phone:225-927-5663
Practice Address - Fax:225-928-7341
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA022133207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1491543Medicaid
G69136Medicare UPIN
5A329Medicare ID - Type Unspecified