Individual
LYNETTE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
604 N SPRING ST, HARRISON, AR 72601-2952
(870) 741-6418
(870) 741-5071
Mailing address
PO BOX 1116, HARRISON, AR 72602-1116
(870) 741-6418
(870) 741-5071
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
E4329
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157673001
—
AR
Enumeration date
02/10/2006
Last updated
02/11/2014
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