Individual
DR. KENNETH R JOHNSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4208 N RODNEY PARHAM RD, LITTLE ROCK, AR 72212-2462
(501) 228-7200
(501) 228-2285
Mailing address
701 N UNIVERSITY, SUITE 201, LITTLE ROCK, AR 72205
(501) 224-1690
(501) 224-1927
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C-7936
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0120146
UNITED HEALTHCARE
AR
01
—
11110000000
QUALCHOICE
AR
Enumeration date
09/07/2005
Last updated
04/18/2008
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