Individual
TIFFANY L JOHNSON
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 546-1000
Mailing address
1919 E THOMAS RD, BLDG. C MANAGED CARE, PHOENIX, AZ 85016-7710
(602) 546-0486
(602) 546-1631
Taxonomy
Speciality
Code
Description
License number
State
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
Primary
34205
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
950263
—
AZ
Enumeration date
04/06/2006
Last updated
07/08/2007
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