Provider Demographics
NPI:1376781906
Name:JOHNSTON, KAREN CECILE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:CECILE
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3693 N RIVER CANYON RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-2113
Mailing Address - Country:US
Mailing Address - Phone:520-904-0249
Mailing Address - Fax:
Practice Address - Street 1:6420 E BROADWAY BLVD
Practice Address - Street 2:SUITE B302
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85710-3534
Practice Address - Country:US
Practice Address - Phone:520-647-9173
Practice Address - Fax:520-647-9263
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-04
Last Update Date:2009-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ226902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry