Johnson, Dan
Johnson, Dan is an individual health care provider with primary practice located at 1201 Fleming Ave , Jonesboro AR 72401. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Neuropsychologist, which is considered as his primary health care specialty. Johnson, Dan can be contacted via phone (870) 933-5174.Contact Information
Primary practice address
1201 Fleming Ave
Jonesboro AR 72401
Phone: (870) 933-5174
Fax: (870) 933-5235
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical Neuropsychologist | 103G00000X | 0110P | Arkansas |
Profile Details
| NPI number | 1720004716 |
|---|---|
| LBN Legal business name | Johnson, Dan |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720004716 | NPPES |
| Arkansas | Other | 5F374 | MEDICARE GROUP # |
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