Individual
MS. CAROL A JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
410 N MALACATE ST, AJO, AZ 85321-2254
(520) 387-5651
(520) 387-6036
Mailing address
410 N MALACATE ST, AJO, AZ 85321-2254
(520) 387-5651
(520) 387-6036
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4080
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
861949
—
AZ
Enumeration date
03/23/2006
Last updated
03/07/2023
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