Johnson, Dwight Joseph
Johnson, Dwight Joseph is an individual health care provider with primary practice located at 2706 Herbert St , Fort Smith AR 72901-4283. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Johnson, Dwight Joseph can be contacted via phone (254) 424-8065.Contact Information
Primary practice address
2706 Herbert St
Fort Smith AR 72901-4283
Phone: (254) 424-8065
Fax: (501) 987-7612
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | E6191 | Arkansas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | M1800 | Texas |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | D61970 | Maryland |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | E6191 | Arkansas |
Profile Details
| NPI number | 1134106743 |
|---|---|
| LBN Legal business name | Johnson, Dwight Joseph |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 23rd, 2005 |
| Last updated | Aug 12th, 2013 - about 12 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 | 1134106743 | NPPES |
| Texas | MEDICAID | 175856701 | |
| Texas | MEDICAID | 179719001 |
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