Individual
BRADLEY R JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6812 N. ORACLE RD, SUITE 114, TUCSON, AZ 85704
(520) 297-9878
(520) 297-2242
Mailing address
6812 N. ORACLE RD, SUITE 114, TUCSON, AZ 85704
(520) 297-9878
(520) 297-2242
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD22029
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
860791409
WPS CHAMPUS TRICARE
—
01
—
AZ0372630
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
12/18/2006
Last updated
01/04/2022
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