Individual
JEFFREY S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2010 ACTIVE WAY, BENTON, AR 72022-9267
(501) 315-0984
(501) 847-1405
Mailing address
2010 ACTIVE WAY, BENTON, AR 72022-9267
(501) 943-9356
(501) 847-1405
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
01011251395
VA
207X00000X
Orthopaedic Surgery Physician
57-013137
OH
207X00000X
Orthopaedic Surgery Physician
9348A
WY
207X00000X
Orthopaedic Surgery Physician
Primary
E10619
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790952406
—
AR
Enumeration date
05/12/2008
Last updated
06/16/2018
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