Individual
DR. NICK J JOHNSON I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
N.M.D.
Contact information
Practice address
9700 N 91ST ST STE A115, SCOTTSDALE, AZ 85258-5036
(480) 322-8577
Mailing address
3757 E SEXTON ST, GILBERT, AZ 85295-7210
(480) 322-8577
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
17-1629
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
495858
—
AZ
Enumeration date
07/01/2017
Last updated
12/30/2019
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