Johnson, Anthony Dale

Johnson, Anthony Dale is an individual health care provider with primary practice located at 500 S. University Ave Ste 200, Little Rock AR 72205. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Johnson, Anthony Dale can be contacted via phone (501) 664-4117.

Contact Information

Primary practice address
500 S. University Ave Ste 200 Little Rock AR 72205
Phone: (501) 664-4117
Fax: (501) 664-1137
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X C-5803 Arkansas

Profile Details

NPI number 1326017005
LBN Legal business name Johnson, Anthony Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 2006
Last updated Oct 11th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1326017005 NPPES
Arkansas MEDICAID 105371001

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