Provider Demographics
NPI:1144271461
Name:JOHNSTON, JANICE G (MD)
Entity type:Individual
Prefix:DR
First Name:JANICE
Middle Name:G
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16390 N 59TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-1711
Mailing Address - Country:US
Mailing Address - Phone:623-334-4000
Mailing Address - Fax:623-334-4400
Practice Address - Street 1:16390 N 59TH AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306
Practice Address - Country:US
Practice Address - Phone:623-334-4000
Practice Address - Fax:623-334-4400
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-12
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ23316207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WDCBR02Medicare ID - Type Unspecified
G22204Medicare UPIN