Healthcare Provider Details

I. General information

NPI: 1144271461
Provider Name (Legal Business Name): JANICE G JOHNSTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 N CENTRAL AVE STE 400
PHOENIX AZ
85004-4510
US

IV. Provider business mailing address

2020 N CENTRAL AVE STE 400
PHOENIX AZ
85004-4510
US

V. Phone/Fax

Practice location:
  • Phone: 888-407-7928
  • Fax:
Mailing address:
  • Phone: 888-407-7928
  • Fax: 800-768-2175

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23316
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: