Johnson, Stephen P

Johnson, Stephen P is an individual health care provider with primary practice located at 3344 N Futrall Dr , Fayetteville AR 72703-4057. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Johnson, Stephen P can be contacted via phone (479) 521-8200.

Contact Information

Primary practice address
3344 N Futrall Dr Fayetteville AR 72703-4057
Fax: (479) 582-7310
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X C-5208 Arkansas

Profile Details

NPI number 1205862174
LBN Legal business name Johnson, Stephen P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Jan 22nd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205862174 NPPES
Oklahoma MEDICAID 100176810B
Oklahoma Other 52681
Oklahoma Other P00194848
Oklahoma MEDICAID 106396001

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