Provider Demographics
NPI:1669438297
Name:JOHNSON, RICHARD HILLSMAN JR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HILLSMAN
Last Name:JOHNSON
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2810 N SWAN RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-6305
Mailing Address - Country:US
Mailing Address - Phone:520-324-2030
Mailing Address - Fax:520-324-2619
Practice Address - Street 1:2810 N SWAN RD
Practice Address - Street 2:SUITE 100
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-6305
Practice Address - Country:US
Practice Address - Phone:520-324-2030
Practice Address - Fax:520-324-2619
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2011-02-07
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Provider Licenses
StateLicense IDTaxonomies
AZ24158207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ346149Medicaid
AZ346149Medicaid
C32698Medicare UPIN