Individual
SUE B JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12635 N 42ND ST, PHOENIX, AZ 85032-7601
(602) 494-5500
Mailing address
12635 N 42ND ST, PHOENIX, AZ 85032-7601
(602) 494-5500
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
24044
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
351693
—
AZ
Enumeration date
01/18/2006
Last updated
07/08/2007
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