Organization
JOHNSON DERMATOLOGY CLINIC PLLC
Active
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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