Johnson, Charles H

Johnson, Charles H is an individual health care provider with primary practice located at 830 Ainsworth Drive , Prescott AZ 86301-1614. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Johnson, Charles H can be contacted via phone (928) 776-0325.

Contact Information

Primary practice address
830 Ainsworth Drive Prescott AZ 86301-1614
Phone: (928) 776-0325
Fax: (928) 776-0405
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 17178 Arizona
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 17178 Arizona

Profile Details

NPI number 1336129667
LBN Legal business name Johnson, Charles H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Apr 11th, 2019 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336129667 NPPES
Arizona MEDICAID 282731

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