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Organization

MYDOCKJ

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KIM D JOHNSON MD (PRESIDENT)
(602) 390-1509
Entity
Organization

Contact information

Practice address
8520 E SHEA BLVD, STE 105, SCOTTSDALE, AZ 85260-6677
(602) 390-1509
Mailing address
10105 E VIA LINDA, STE 103-364, SCOTTSDALE, AZ 85258-5311
(602) 390-1509

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19257
AZ

Other

Enumeration date
02/20/2012
Last updated
02/20/2012
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