Individual
FELICIA JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
601 W MAPLE AVE STE 213, SPRINGDALE, AR 72764-5397
(479) 750-2080
(479) 750-2082
Mailing address
601 W MAPLE AVE STE 213, SPRINGDALE, AR 72764-5397
(479) 750-2080
(479) 750-2082
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
E-3699
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149922001
—
AR
01
—
P00032442
RAILROAD MEDICARE
AR
01
—
P00032443
RAILROAD MEDICARE
AR
Enumeration date
10/13/2006
Last updated
12/02/2008
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