Provider Demographics
NPI:1558519959
Name:JOHNSON, CURTIS MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:MICHAEL
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3085 N SWAN RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-1259
Mailing Address - Country:US
Mailing Address - Phone:520-323-3099
Mailing Address - Fax:520-323-3460
Practice Address - Street 1:3085 N SWAN RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-1259
Practice Address - Country:US
Practice Address - Phone:520-323-3099
Practice Address - Fax:520-323-3460
Is Sole Proprietor?:No
Enumeration Date:2008-08-28
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR70640208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics