Johnson, Brent E
Johnson, Brent E is an individual health care provider with primary practice located at 1000 Ainsworth Dr Suite 115, Prescott AZ 86305-1667. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Johnson, Brent E can be contacted via phone (928) 778-1971.Contact Information
Primary practice address
1000 Ainsworth Dr Suite 115
Prescott AZ 86305-1667
Phone: (928) 778-1971
Fax: (928) 443-8473
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 20366 | Arizona |
Profile Details
| NPI number | 1487640447 |
|---|---|
| LBN Legal business name | Johnson, Brent E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 26th, 2005 |
| Last updated | Jul 25th, 2011 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487640447 | NPPES |
| Arizona | MEDICAID | 069709 |
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