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Individual

DR. BRENDA CAMILLE JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
US HWY 160 & NAVAJO RT 35, TEEC NOS POS, AZ 86514
(928) 656-5474
Mailing address
US HWY 160 & NAVAJO RT 35, HCR 6100 BOX 30, TEEC NOS POS, AZ 86514
(928) 656-5474

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD22804
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
287966
OR
Enumeration date
12/20/2006
Last updated
03/27/2024
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