Provider Demographics
NPI:1669497657
Name:JOHNSTON, CURTIS A (MD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:A
Last Name:JOHNSTON
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 1:6655 NORTH MACARTHUR BLVD.
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-2443
Mailing Address - Country:US
Mailing Address - Phone:602-464-7500
Mailing Address - Fax:
Practice Address - Street 1:4610 SOUTH 44TH PLACE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85040-4010
Practice Address - Country:US
Practice Address - Phone:602-464-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-12
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT35236207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT061344026OtherOXFORD HEALTH#
CT061344026OtherCIGNA#
CT500HBL160CT01OtherBLUE CARE FAMILY PLAN
CT061344026OtherUNITED HEALTHCARE#
CT061344026OtherAETNA/US HESALTHCARE#
CT500HBL160CT01OtherBC/BS#
CT744026OtherCONNECTICARE#
CTC009155OtherCHAMPUS/TRICARE#
CT032344OtherHEALTHNET#
CT001352369Medicaid
CT032344OtherHEALTHNET#
CT500HBL160CT01OtherBC/BS#