MEDICARE: PAIGE JOHNSON MD

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	2085R0204X	Vascular & Interventional Radiology Physician	67905	MN
2	2085R0204X	Vascular & Interventional Radiology Physician	E-19126	AR

General Provider Information

NPI Number	:	1922560747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAIGE JOHNSON MD

Provider Business Mailing Address
First Line	:	500 S UNIVERSITY AVE STE 101
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-5314
Country	:	US
Telephone Number	:	501-686-2688
Fax Number	:

Provider Business Practice Location Address
First Line	:	4301 W MARKHAM ST # 520
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72205-7101
Country	:	US
Telephone Number	:	501-686-6627
Fax Number	:

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

Provider Enumeration Date	:	04/01/2019
Last Update Date	:	04/13/2026

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Directions to “ PAIGE JOHNSON MD” Practice Location

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