Johnson, Frederick Dwayne

Johnson, Frederick Dwayne is an individual health care provider with primary practice located at 5 Woods Cv , Little Rock AR 72210-9108. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Johnson, Frederick Dwayne can be contacted via phone (501) 348-5797.

Contact Information

Primary practice address
5 Woods Cv Little Rock AR 72210-9108
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 51504 Tennessee

Profile Details

NPI number 1619143914
LBN Legal business name Johnson, Frederick Dwayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 6th, 2008
Last updated Jun 10th, 2016 - about 9 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 1619143914 NPPES
Tennessee MEDICAID Q007629

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