Individual
DR. CHRYSTAL DIAN JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
20602 ARCH STREET PIKE, HENSLEY, AR 72065-9442
(501) 262-2602
(501) 891-5672
Mailing address
20602 ARCH STREET PIKE, HENSLEY, AR 72065-9442
(501) 262-2602
(501) 891-5672
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-3700
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04010017400
QUALCHOICE
AR
05
—
150345001
—
AR
01
—
1670460
UNITED HEALTHCARE
AR
01
—
5M652
BLUE CROSS BLUE SHIELD
AR
01
—
P000900296
RR MEDICARE
AR
Enumeration date
10/17/2006
Last updated
10/25/2023
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