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General NPI Number Information
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NPI Number | 1245595388
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Entity Type | Individual
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Provider Name | JOSHUA MICHAEL JOHNSTON MD
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Gender | Male
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Dates
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Enumeration Date | 07/04/2012
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Last Update Date | 04/20/2020
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Provider Practice Location Address
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Address Line | 1253 NW CANAL BLVD
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City | REDMOND
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State | OR
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Zip | 97756-1334
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Country | US
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Telephone | 541-548-8131
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Fax |
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Provider Business Mailing Address
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Address Line | 3404 W RED BIRD CT
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City | TUCSON
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State | AZ
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Zip | 85745-5112
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Country | US
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Telephone | 229-630-4756
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | R73260
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License Number State | AZ
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