Johnson, Larry Austin
Johnson, Larry Austin is an individual health care provider with primary practice located at 225 E Jackson Ave , Jonesboro AR 72401-3119. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Johnson, Larry Austin can be contacted via phone (870) 932-0639.Contact Information
Primary practice address
225 E Jackson Ave
Jonesboro AR 72401-3119
Phone: (870) 932-0639
Fax: (870) 932-0526
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | E3004 | Arkansas |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | E3004 | Arkansas |
Profile Details
| NPI number | 1841292000 |
|---|---|
| LBN Legal business name | Johnson, Larry Austin |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 1st, 2005 |
| Last updated | Nov 17th, 2023 - about 3 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 | 1841292000 | NPPES |
| Missouri | MEDICAID | 208791806 | |
| Missouri | MEDICAID | 149994001 |
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