Individual
STANLEY JOHNSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222 W THOMAS RD, SUITE 304, PHOENIX, AZ 85013-4419
(602) 406-3800
(602) 406-3810
Mailing address
FILE 56765, LOS ANGELES, CA 90074-6765
(602) 406-3860
(602) 406-6132
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
6324
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
412007
—
AZ
Enumeration date
08/18/2006
Last updated
04/24/2012
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