Provider Demographics
NPI:1154399590
Name:JOHNSON, ARTHUR M (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:M
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11001 EXECUTIVE CENTER DR STE 200
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-4393
Mailing Address - Country:US
Mailing Address - Phone:479-709-7175
Mailing Address - Fax:479-709-7180
Practice Address - Street 1:1500 DODSON AVE STE 290
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72901-5182
Practice Address - Country:US
Practice Address - Phone:479-709-7175
Practice Address - Fax:479-709-7180
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE1847207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR7792017OtherAETNA
AR904210OtherUSA MCO
AR5K961OtherARKANSAS BLUE CROSS
AR17927000000OtherQUALCHOICE
AR140006357OtherRAILROAD MEDICARE
AR135105001Medicaid
AR3406633OtherCIGNA
AR0620035OtherUNITED HEALTHCARE
OK100070860AOtherOKLAHOMA MEDICAID
AR7792017OtherAETNA
AR140006357OtherRAILROAD MEDICARE