DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. MILES MCHANEY JOHNSON, M.D.

Active Sole Proprietor

DR. MILES MCHANEY JOHNSON, M.D. is a 204R00000X healthcare provider located in FAYETTEVILLE, Arkansas. NPI 1811928013 is currently active in the NPPES registry. Verify at CMS.

204R00000X · FAYETTEVILLE, AR

Registration Details

NPI Number
1811928013
Provider Type
Individual
Gender
Male
NPI Issued
Jul 5, 2006 (20.156523936145 yrs)
Last Updated
Feb 14, 2013
Licenses
E-0060 (AR)
E0060 (AR)
E0060 (AR)
Sole Proprietor
Yes

Practice Information

Address
2820 E MILLENNIUM PL
SUITE 1
FAYETTEVILLE, AR, 727036514
Browse AR providers · Browse ZIP 72703
Phone
4792518055
Fax
4792511511
Primary Specialty
204R00000X
204R00000X
Additional Specialty
204R00000X

Other 204R00000X Providers in FAYETTEVILLE, AR

Name Credential NPI
TYLER ESTES MD 1912586454
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.