Organization
JOHNSON DERMATOLOGY CLINIC PLLC
Active
Other names
Johnson Dermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDRA MARCHESE JOHNSON MD (GENERAL MANAGER)
(479) 649-3376
Entity
Organization
Contact information
Practice address
5921 RILEY PARK DR, FORT SMITH, AR 72916-6103
(479) 649-3376
(479) 646-0133
Mailing address
5921 RILEY PARK DR, FORT SMITH, AR 72916-6103
(479) 649-3376
(479) 646-0133
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MC-2480
AR
207N00000X
Dermatology Physician
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
Other
Enumeration date
04/02/2006
Last updated
08/31/2023
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