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Contact Information

DERRICK V JOHNSON
114 DYER STREET
MOUNTAIN HOME, AR72653
 Phone: 870-580-0950
 Fax: 870-580-0951
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for DERRICK V JOHNSON · (Male)

NPI Number 1407963762
Status Active
Credentials
Entity Individual
Enumeration date 08/24/2006
Last updated 06/09/2015 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • AR License # AR3739
  • AZ License # 4583
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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