Individual
DR. KIRK ROBERT JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
715 N COLLEGE AVE, FAYETTEVILLE, AR 72701-3407
(479) 442-0352
(479) 442-4181
Mailing address
715 N COLLEGE AVE, FAYETTEVILLE, AR 72701-3407
(479) 442-0352
(479) 442-4181
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
933
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14821000040
QUAL CHOICE OF AR
AR
01
—
7875281
AETNA
—
Enumeration date
08/31/2005
Last updated
07/08/2007
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