Individual
DR. MICHAEL MACKENZIE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14678 N DEL WEBB BLVD, SUN CITY, AZ 85351-2137
(623) 933-8289
(623) 933-2596
Mailing address
14678 N DEL WEBB BLVD, SUN CITY, AZ 85351-2137
(623) 933-8289
(623) 933-2596
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12960
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110061076
RAILROAD MEDICARE
AZ
01
—
AZ0054230
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
08/24/2005
Last updated
09/09/2016
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