Johnson, Brad Dale
Johnson, Brad Dale is an individual health care provider with primary practice located at 2710 Rife Medical Ln , Rogers AR 72758-1452. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Johnson, Brad Dale can be contacted via phone (479) 338-0200.Contact Information
Primary practice address
2710 Rife Medical Ln
Rogers AR 72758-1452
Phone: (479) 338-0200
Fax: (479) 338-3388
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | E-1424 | Arkansas |
Profile Details
| NPI number | 1780734830 |
|---|---|
| LBN Legal business name | Johnson, Brad Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 11th, 2007 |
| Last updated | Oct 28th, 2022 - about 4 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 | 1780734830 | NPPES |
| Arkansas | MEDICAID | 135003001 |
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