Individual
JASON JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
200 W. HOSPITAL DR., WHITERIVER, AZ 95491-0860
(928) 338-4911
Mailing address
200 W. HOSPITAL DR., WHITERIVER, AZ 95491-0860
(928) 338-4911
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
40617
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1295993376
—
AZ
05
—
1427335140
—
AZ
05
—
1427335181
—
AZ
05
—
1629236716
—
AZ
05
—
353135
—
AZ
Enumeration date
02/20/2007
Last updated
03/13/2012
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