Johanson, Timothy David

Johanson, Timothy David is an individual health care provider with primary practice located at 1501 N. Campbell Ave. , Tucson AZ 85724. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Johanson, Timothy David can be contacted via phone (952) 920-9191.

Contact Information

Primary practice address
1501 N. Campbell Ave. Tucson AZ 85724
Phone: (952) 920-9191
Fax: (952) 920-0232
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 33782 Minnesota
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 51152 Arizona

Profile Details

NPI number 1578577441
LBN Legal business name Johanson, Timothy David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Feb 8th, 2016 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578577441 NPPES
Other 1200632 MEDICA
MEDICAID 496002500 MEDICA
Other CP9020830013 MEDICA
Other 47B40JO MEDICA

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