STACEY M JOHNSON MD PA NPI 1831203512

NPI Information

  • NPI: 1831203512
  • Provider Name: STACEY M JOHNSON MD PA
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Doing Business As: PHYSICIANS MEDICAL CENTER OF THE OZARKS
  • Address: # 17 MEDICAL PLAZA
    MOUNTAIN HOME, AR
    ZIP 72653
  • Phone: (870) 425-6212

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NPI Details

STACEY M JOHNSON MD PA is a specialist in Mountain Home, AR. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. STACEY M JOHNSON MD PA NPI is 1831203512. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Physicians Medical Center Of The Ozarks.

The provider's business location address is:

# 17 MEDICAL PLAZA
MOUNTAIN HOME, AR
ZIP 72653
Phone: (870) 425-6212
Fax: (870) 424-3774

The provider's authorized official is Pete Ross .
The authorized official title is Coo Vp Of Operations and has the following contact phone number (870) 425-6212.

The enumeration date for this NPI number is 8/18/2006 and was last updated on 5/29/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialistR2724ARKANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
157598OTHERARKANSASAR BCBS PROV
2111814002MEDICAIDARKANSAS
357598MEDICARE ID-TYPE UNSPECIFIEDARKANSASMEDICARE PROVIDER #

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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