Provider Demographics
NPI:1144214578
Name:JOHNS, RICHARD D (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:D
Last Name:JOHNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7570
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72217-7570
Mailing Address - Country:US
Mailing Address - Phone:501-661-8207
Mailing Address - Fax:501-661-0304
Practice Address - Street 1:500 S UNIVERSITY AVE
Practice Address - Street 2:SUITE 615
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5302
Practice Address - Country:US
Practice Address - Phone:501-666-3666
Practice Address - Fax:501-663-0638
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE1846207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR134618001Medicaid
ARG69238Medicare UPIN
AR5K771Medicare ID - Type Unspecified