Johnson, Charles H
Johnson, Charles H is an individual health care provider with primary practice located at 830 Ainsworth Drive , Prescott AZ 86301-1614. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Johnson, Charles H can be contacted via phone (928) 776-0325.Contact Information
Primary practice address
830 Ainsworth Drive
Prescott AZ 86301-1614
Phone: (928) 776-0325
Fax: (928) 776-0405
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 17178 | Arizona |
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 17178 | Arizona |
Profile Details
| NPI number | 1336129667 |
|---|---|
| LBN Legal business name | Johnson, Charles H |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 20th, 2006 |
| Last updated | Apr 11th, 2019 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336129667 | NPPES |
| Arizona | MEDICAID | 282731 |
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