Individual
DR. JEFFREY WILLIAM JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3317 N WIMBERLY DR, FAYETTEVILLE, AR 72703-4056
(479) 521-2752
(479) 444-6942
Mailing address
PO BOX 1608, FAYETTEVILLE, AR 72702-1608
(479) 587-3130
(479) 444-6942
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
E6007
AR
207XS0106X
Orthopaedic Hand Surgery Physician
Primary
E6007
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386863611
BLUE CROSS BLUE SHEILD
AR
05
—
1785010010
—
AR
Enumeration date
04/25/2007
Last updated
07/12/2021
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