Individual
DR. MICHAEL BRUCE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
409 N UNIVERSITY AVE, LITTLE ROCK, AR 72205-3108
(501) 664-6980
(501) 664-4738
Mailing address
409 N UNIVERSITY AVE, LITTLE ROCK, AR 72205-3108
(501) 664-6980
(501) 664-4738
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
N7853
AR
207RG0100X
Gastroenterology Physician
Primary
N7853
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117492001
—
AR
Enumeration date
06/09/2005
Last updated
12/12/2016
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