| NPI | 1205869229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAIL R. JOHNSON Physician/Secretary And Treasurer 479-582-1199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2008-02-19 |