MEDICARE: DR. ROBERT D JOHNSON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	C-4606	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811991896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT D JOHNSON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 21850
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71903-1850
Country	:	US
Telephone Number	:	501-627-1800
Fax Number	:	501-627-1899

Provider Business Practice Location Address
First Line	:	1 MERCY LN
Second Line	:	STE 401
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-6441
Country	:	US
Telephone Number	:	501-623-5220
Fax Number	:	501-623-1546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	06/29/2016

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