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Individual

DR. MILES MCHANEY JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2820 E MILLENNIUM PL, SUITE 1, FAYETTEVILLE, AR 72703-6514
(479) 251-8055
(479) 251-1511
Mailing address
PO BOX 9450, FAYETTEVILLE, AR 72703-0025
(479) 251-8055
(479) 251-1511

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
E-0060
AR
204R00000X
Electrodiagnostic Medicine Physician
Primary
E0060
AR
208100000X
Physical Medicine & Rehabilitation Physician
E0060
AR

Other

Enumeration date
07/05/2006
Last updated
02/14/2013
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