Individual
MR. TIMOTHY RALPH JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2014 N CITRUS RD, GOODYEAR, AZ 85338
(623) 853-0304
Mailing address
17166 W COTTONWOOD ST, SURPRISE, AZ 85388-1203
(623) 544-0462
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3698
AZ
Other
Enumeration date
10/01/2009
Last updated
10/01/2009
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