Organization
JASON DANIEL JOHNSON, PLLC
Active
Other names
PHX Plastic Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
JASON D JOHNSON DO (OWNER)
(602) 610-2999
Entity
Organization
Contact information
Practice address
15396 N 83RD AVE STE B100, PEORIA, AZ 85381-5626
(602) 610-2999
(623) 321-7821
Mailing address
15396 N 83RD AVE STE B100, PEORIA, AZ 85381-5626
(602) 610-2999
(623) 321-7821
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
006929
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
033104
—
AZ
Enumeration date
09/28/2017
Last updated
04/06/2020
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