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General NPI Number Information
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NPI Number | 1962750810
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Entity Type | Organization
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Legal Business Name | DAVID R JOHNSON MD PC
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Dates
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Enumeration Date | 08/27/2012
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Last Update Date | 08/27/2012
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Provider Practice Location Address
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Address Line | 10619 N HAYDEN RD SUITE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-8529
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Country | US
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Telephone | 480-948-0733
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Fax | 480-443-5611
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Provider Business Mailing Address
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Address Line | 10619 N HAYDEN RD SUITE 101
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City | SCOTTSDALE
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State | AZ
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Zip | 85260-8529
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Country | US
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Telephone | 480-948-0733
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Fax | 480-443-5611
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID RODRIC JOHNSON
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Credential | MD
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Telephone | 480-948-0733
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 10913
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License Number State | AZ
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