Search › Arkansas › 122300000X
Derrick Johnson
NPI 1407963762 · on the registry since 2006 · sole proprietor
Practice
- Address
- 114 Dyer Street
Mountain Home, AR 72653 - Phone
- (870) 580-0950
- Fax
- (870) 580-0951
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Also registered as
- 122300000X
- Licence states on file
- AZ, AR
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2015-06-09
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arkansas