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General NPI Number Information
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NPI Number | 1225272289
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Entity Type | Individual
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Provider Name | COLLIN D JOHNSTON DO
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Gender | Male
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Dates
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Enumeration Date | 04/21/2009
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 1520 S DOBSON RD STE 202
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City | MESA
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State | AZ
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Zip | 85202-4726
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Country | US
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Telephone | 480-725-7241
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Fax |
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Provider Business Mailing Address
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Address Line | 4077 E CULLUMBER ST
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City | GILBERT
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State | AZ
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Zip | 85234-0719
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Country | US
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Telephone | 702-803-4539
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 011209
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 011209
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 202K00000X
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Taxonomy Name | Phlebology Physician
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License Number | 928
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License Number State | AZ
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