Individual
DR. GAIL R JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPM
Contact information
Practice address
2828 E MILLENNIUM PL, SUITE 2, FAYETTEVILLE, AR 72703-6514
(479) 582-1199
(479) 582-1194
Mailing address
2828 E MILLENNIUM PL, SUITE 2, FAYETTEVILLE, AR 72703-6514
(479) 582-1199
(479) 582-1194
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
185
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184
BLUE CROSS
AR
01
—
5X001
BLUE SHIELD
AR
Enumeration date
07/19/2006
Last updated
02/19/2008
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