Provider Demographics
NPI:1356545040
Name:JOHNSON, VAN ALLAN JR (MD)
Entity type:Individual
Prefix:DR
First Name:VAN
Middle Name:ALLAN
Last Name:JOHNSON
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:9250 N 3RD ST
Mailing Address - Street 2:SUITE 3015
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85020-2437
Mailing Address - Country:US
Mailing Address - Phone:602-633-3722
Mailing Address - Fax:602-595-1127
Practice Address - Street 1:9250 N 3RD ST
Practice Address - Street 2:SUITE 3015
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85020-2437
Practice Address - Country:US
Practice Address - Phone:602-633-3722
Practice Address - Fax:602-595-1127
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2016-10-26
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Provider Licenses
StateLicense IDTaxonomies
TXP1465208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery