Timothy Samuel Johnson (NPI# 1023074119, PAC ID# 3375536303) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1023074119 |
| PAC ID by PECOS | 3375536303 |
| Professional Enrollment ID | I20040406000815 |
| Full Name | Timothy Samuel Johnson |
| Organization Legal Name | ST MARYS PHYSICIAN SERVICES LLC |
| Address |
1601 N Church St Millard Henry Clinic Atkins AR 72823-3234 |
| Phone Number | 4796412255 |
| Gender | M |
| Credential | MD |
| Medical School | UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE |
| Graduation Year | 1999 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 4981698032 |
| Number of Group Practice Members | 58 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 040041 | ST MARYS REGIONAL MEDICAL CENTER |
| 040114 | BAPTIST HEALTH MEDICAL CENTER-LITTLE ROCK |
| 040154 | BAPTIST HEALTH MEDICAL CENTER-CONWAY |
| Address | Phone | Organization |
|---|---|---|
| 1601 N Church St, Millard Henry Clinic, Atkins, AR 72823-3234 | 4796412255 | ST MARYS PHYSICIAN SERVICES LLC |
| Organization Legal Name | ST MARYS PHYSICIAN SERVICES LLC |
| Physicians | 66 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Stephen C. Dobratz | Internal Medicine | St Marys Physician Services LLC | 2205 W Main St, Cardiology Assoc of North Central Arkansas, Russellville, AR 72801-2759 |
| James Albert Johnson | General Surgery | St Marys Physician Services LLC | 101 Skyline Dr, Russellville, AR 72801-3363 |
| Nathan R Henderson | Family Medicine | St Marys Physician Services LLC | 8970 Market St, Dover, AR 72837-9110 |
| Jody C Callaway | Obstetrics/gynecology | St Marys Physician Services LLC | 105 Skyline Dr, Russellville, AR 72801-3363 |
| Sara Damron | Nurse Practitioner | St Marys Physician Services LLC | 1808 W Main St, Russellville, AR 72801-2724 |
| Janet K Corbett | Family Medicine | St Marys Physician Services LLC | 101 Skyline Dr, Russellville, AR 72801-3363 |
| Jennifer Jacobs | Nurse Practitioner | St Marys Physician Services LLC | 1601 N Church St, Millard Henry Clinic, Atkins, AR 72823-3234 |
| Thomas Reinsvold | Interventional Cardiology | St Marys Physician Services LLC | 2205 W Main St, Cardiology Assoc of North Central Arkansas, Russellville, AR 72801-2759 |
| Anthony C Davis | Neurology | St Marys Physician Services LLC | 1808 W Main St, Russellville, AR 72801-2724 |
| Noma W Kellner | Nurse Practitioner | St Marys Physician Services LLC | 101 Skyline Dr, Russellville, AR 72801-3363 |
| Street Address |
1601 N CHURCH ST MILLARD HENRY CLINIC |
| City | ATKINS |
| State | AR |
| Zip | 72823-3234 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jennifer Jacobs | Nurse Practitioner | St Marys Physician Services LLC | 1601 N Church St, Millard Henry Clinic, Atkins, AR 72823-3234 |
| Chris Howell Horan | Family Practice | St Marys Physician Services LLC | 1601 N Church St, Atkins, AR 72823-3234 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Danny R Lyons | Physical Therapy | 408 N Church St, Atkins, AR 72823-4149 |
| City | ATKINS |
| Zip Code | 72823 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | ATKINS + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Timothy Samuel Johnson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.