Organization
EM MEDICAL MANAGEMENT OF FORT MOHAVE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FREDERICK JOHNSON MD (PRESIDENT)
(219) 629-0453
Entity
Organization
Contact information
Practice address
5330 S HIGHWAY 95, FORT MOHAVE, AZ 86426-9225
(928) 788-7069
Mailing address
307 W ALAMOSA DR, CHANDLER, AZ 85248-5303
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Enumeration date
09/08/2016
Last updated
09/09/2016
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