Individual
DR. BRAD DALE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2710 RIFE MEDICAL LN, ROGERS, AR 72758-1452
(479) 338-0200
(479) 338-3388
Mailing address
2710 RIFE MEDICAL LN, ROGERS, AR 72758-1452
(479) 338-0200
(479) 338-3388
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
E-1424
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135003001
—
AR
Enumeration date
01/11/2007
Last updated
10/28/2022
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