Organization
ARKANSAS PROSTHETICS AND PEDORTHICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL EDGAR JOHNSTON C.P., C-PED (OWNER)
(501) 860-6910
Entity
Organization
Contact information
Practice address
119 W CARPENTER ST, BENTON, AR 72015-3317
(501) 860-6910
(501) 860-7587
Mailing address
119 W CARPENTER ST, BENTON, AR 72015-3317
(501) 860-6910
(501) 860-7587
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
156100716
—
AR
01
—
49920
AR BLUECROSS BLUESHIELD
AR
Enumeration date
02/23/2007
Last updated
09/30/2009
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