Johnson, Michael Bruce

Johnson, Michael Bruce is an individual health care provider with primary practice located at 409 N University Ave , Little Rock AR 72205-3108. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Johnson, Michael Bruce can be contacted via phone (501) 664-6980.

Contact Information

Primary practice address
409 N University Ave Little Rock AR 72205-3108
Phone: (501) 664-6980
Fax: (501) 664-4738
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X N7853 Arkansas
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X N7853 Arkansas

Profile Details

NPI number 1134123813
LBN Legal business name Johnson, Michael Bruce
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Dec 12th, 2016 - about 8 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 1134123813 NPPES
Arkansas MEDICAID 117492001

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