Provider Demographics
NPI:1275906570
Name:MCGEE, JOHNNY
Entity Type:Individual
Prefix:MR
First Name:JOHNNY
Middle Name:
Last Name:MCGEE
Suffix:
Gender:M
Credentials:
Other - Prefix:MRS
Other - First Name:DANNA
Other - Middle Name:LARIE
Other - Last Name:MCGEE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4 GLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71202-7306
Mailing Address - Country:US
Mailing Address - Phone:318-547-0705
Mailing Address - Fax:318-362-5683
Practice Address - Street 1:4 GLENDALE DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-7306
Practice Address - Country:US
Practice Address - Phone:318-547-0705
Practice Address - Fax:318-362-5683
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-09
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)