Johnson, Courtney R

Johnson, Courtney R is an individual health care provider with primary practice located at 1432 S Dobson Rd Suite 501, Mesa AZ 85202-4768. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Rheumatology. Allopathic & Osteopathic Physicians / Pediatric Rheumatology is his primary health care specialty. Johnson, Courtney R can be contacted via phone (480) 412-7457.

Contact Information

Primary practice address
1432 S Dobson Rd Suite 501 Mesa AZ 85202-4768
Phone: (480) 412-7457
Fax: (480) 412-7475
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2000213 New Mexico
Allopathic & Osteopathic Physicians / Pediatric Rheumatology 2080P0216X 19112 Arizona

Profile Details

NPI number 1902827694
LBN Legal business name Johnson, Courtney R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Mar 17th, 2016 - about 9 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 1902827694 NPPES
New Mexico MEDICAID L3714
New Mexico MEDICAID 289703
New Mexico MEDICAID 116055900

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