Individual
DR. JAMES ALBERT JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
101 SKYLINE DR, RUSSELLVILLE, AR 72801-3363
(479) 968-2345
Mailing address
2534 S BIRMINGHAM PL, TULSA, OK 74114-3226
(918) 625-3300
(479) 890-2497
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
11075
OK
208600000X
Surgery Physician
Primary
C-4945
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100074240A
—
OK
05
—
152160001
—
AR
Enumeration date
05/01/2006
Last updated
01/27/2020
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