Johnson, Keith
Johnson, Keith is an individual health care provider with primary practice located at 2301 Morningside Dr , Jonesboro AR 72404-8050. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Johnson, Keith can be contacted via phone (870) 680-2626.Contact Information
Primary practice address
2301 Morningside Dr
Jonesboro AR 72404-8050
Phone: (870) 680-2626
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT 8230 | Tennessee |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT1729 | Arkansas |
Profile Details
| NPI number | 1972669646 |
|---|---|
| LBN Legal business name | Johnson, Keith |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 28th, 2006 |
| Last updated | Apr 30th, 2018 - about 7 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 | 1972669646 | NPPES |
| Arkansas | MEDICAID | 133568721 |
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