Thomas J Johnson, PD

Individual provider Active NPI Pharmacist · Quitman, AR

NPI 1578618310 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1578618310
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
PD05864 (AR)
Practice address
6124 Heber Springs Rd West
Quitman, AR 72131-0164
Phone
(501) 589-2890
Fax
(501) 589-3780
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PD05864ARMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Pharmacy Pharmacist Current Accepting new patients

Locations

6124 Heber Springs Rd W
Quitman, AR 72131
Phone (501) 589-2890

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PD05864 AR Yes

Addresses

Primary practice location

6124 Heber Springs Rd West
Quitman, AR 72131-0164

Mailing address

6124 Heber Springs Rd West
Quitman, AR 72131-0164
Phone (501) 589-2890

Other providers in Quitman, AR

All providers in Quitman, AR · Pharmacist in Arkansas

Sources for this page

Verify at the official NPI Registry.