Basic Information
| Provider Information | |||||||||
| NPI: | 1154399590 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOHNSON | ||||||||
| FirstName: | ARTHUR | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11001 EXECUTIVE CENTER DR STE 200 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722114393 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4797097175 | ||||||||
| FaxNumber: | 4797097180 | ||||||||
| Practice Location | |||||||||
| Address1: | 1500 DODSON AVE STE 290 | ||||||||
| Address2: | |||||||||
| City: | FORT SMITH | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729015182 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4797097175 | ||||||||
| FaxNumber: | 4797097180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 06/22/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/22/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | E1847 | AR | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 7792017 | 01 | AR | AETNA | OTHER | 904210 | 01 | AR | USA MCO | OTHER | 5K961 | 01 | AR | ARKANSAS BLUE CROSS | OTHER | 17927000000 | 01 | AR | QUALCHOICE | OTHER | 140006357 | 01 | AR | RAILROAD MEDICARE | OTHER | 135105001 | 05 | AR | MEDICAID | 3406633 | 01 | AR | CIGNA | OTHER | 0620035 | 01 | AR | UNITED HEALTHCARE | OTHER | 100070860A | 01 | OK | OKLAHOMA MEDICAID | OTHER |