Individual provider · NPI-1
Collin D Johnston, DO
Phlebology · Mesa, AZ
NPI number1225272289
StatusActive
Last updated in NPPESFeb 27, 2025
Details
- NPI
- 1225272289
- Entity type
- Individual (NPI-1)
- Name
- Collin D Johnston
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 21, 2009
- Certification date
- Feb 27, 2025
- Last updated
- Feb 27, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 202K00000X | Phlebology | 928 | AZ | Yes |
| 207Q00000X | Family Medicine | 011209 | AZ | |
| 2086S0129X | 011209 | AZ |
Practice location
1520 S Dobson Rd Ste 202Mesa, AZ 85202-4726
Phone 480-725-7241
Mailing address
4077 E Cullumber StGilbert, AZ 85234-0719
Phone 702-803-4539
Other practice locations
600 S Dobson Rd Ste C26
Chandler, AZ 85224-5690
Chandler, AZ 85224-5690
Phone 480-814-1560
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