Individual
DR. LARRY AUSTIN JOHNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
225 E JACKSON AVE, JONESBORO, AR 72401-3119
(870) 932-0639
(870) 932-0526
Mailing address
800 S CHURCH ST STE 101, JONESBORO, AR 72401-4154
(870) 932-0639
(870) 932-0526
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
E3004
AR
2085R0204X
Vascular & Interventional Radiology Physician
Primary
E3004
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149994001
—
AR
05
—
208791806
—
MO
Enumeration date
06/01/2005
Last updated
11/17/2023
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