Robert Leroy Johnson

Individual provider Active NPI Attendant Care Provider · Hardy, AR

NPI 1053945352 · NPPES record last updated Jun 10, 2020

Key facts

NPI
1053945352
Entity type
Individual (NPI type 1)
Primary specialty
Attendant Care Provider 3747A0650X
Practice address
29 Tucker Rd
Hardy, AR 72542-9115
Phone
(870) 955-0972
NPI assigned
Feb 25, 2020
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Attendant Care Provider 3747A0650X Yes

Addresses

Primary practice location

29 Tucker Rd
Hardy, AR 72542-9115

Mailing address

29 Tucker Rd.
Hardy, AR 72542
Phone (870) 955-0972

Other providers in Hardy, AR

All providers in Hardy, AR · Attendant Care Provider in Arkansas

Sources for this page

Verify at the official NPI Registry.