Individual
DR. ALLISON M JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
688 E MILLSAP RD, SUITE 100, FAYETTEVILLE, AR 72703-4095
(479) 463-3070
(479) 463-3077
Mailing address
688 E MILLSAP RD, SUITE 100, FAYETTEVILLE, AR 72703-4095
(479) 463-3070
(479) 463-3077
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
E-4712
AR
207R00000X
Internal Medicine Physician
MD432823
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06070016900
QUALCHOICE
AR
05
—
162911001
—
AR
01
—
E4712
TRICARE
AR
01
—
P00375097
RAILROAD MEDICARE
AR
Enumeration date
09/22/2006
Last updated
01/17/2013
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