Organization
MILES M JOHNSON, M.D. P.A.
Active
Other names
Northwest Arkansas EMG Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILES M JOHNSON MD (PRESIDENT/DOCTOR)
(479) 251-8055
Entity
Organization
Contact information
Practice address
2820 E MILLENNIUM PL, SUITE 1, FAYETTEVILLE, AR 72703-6514
(479) 251-8055
Mailing address
PO BOX 9450, FAYETTEVILLE, AR 72703-0025
(479) 251-8055
(479) 251-1511
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100848150A
—
OK
05
—
155016002
—
AR
Enumeration date
08/22/2005
Last updated
06/14/2013
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