# PROFESSIONAL NATURAL MEDICAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Professional Natural Medical
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407495286
- **Authorized official:** DR. NICK JAMES JOHNSON NMD (PHYSICIAN)
- **Authorized official phone:** (480) 322-8577

## Contact information

- **Practice address:** 9700 N 91ST ST STE A115, SCOTTSDALE, AZ 85258-5036
- **Practice address phone:** (480) 322-8577
- **Mailing address:** NICKJOHNSON369021@OUTLOOK.COM, 1432 W. BIRCH RD, SAN TAN VALLEY, AZ 85140
- **Mailing address phone:** (480) 322-8577

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/27/2019
- **Last updated:** 09/02/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 495858 | — | AZ |