Provider Demographics
NPI:1023088531
Name:JOHNSON, DAVID CURTIS (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CURTIS
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10031 E KILAREA AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85209-1257
Mailing Address - Country:US
Mailing Address - Phone:480-332-6240
Mailing Address - Fax:480-323-2858
Practice Address - Street 1:10031 E KILAREA AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85209-1257
Practice Address - Country:US
Practice Address - Phone:480-332-6240
Practice Address - Fax:480-323-2858
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14158208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD44073Medicare UPIN
AZZ111892Medicare PIN