Basic Information
| Provider Information | |||||||||
| NPI: | 1104880830 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOHNSON | ||||||||
| FirstName: | ARTHUR | ||||||||
| MiddleName: | ALLEN | ||||||||
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| Credential: | PA-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20926 N LAUREN RD | ||||||||
| Address2: | |||||||||
| City: | MARICOPA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 851386881 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5203133121 | ||||||||
| FaxNumber: | 9198829575 | ||||||||
| Practice Location | |||||||||
| Address1: | 890 W ELLIOT RD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | GILBERT | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852335102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4805452787 | ||||||||
| FaxNumber: | 9198829575 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/12/2006 | ||||||||
| LastUpdateDate: | 04/16/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 3189 | AZ | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical | 363A00000X | 3189 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.