Basic Information
| Provider Information | |||||||||
| NPI: | 1669497657 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | JOHNSTON | ||||||||
| FirstName: | CURTIS | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6655 NORTH MACARTHUR BLVD. | ||||||||
| Address2: | 3RD FLOOR | ||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750392443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024647500 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 4610 SOUTH 44TH PLACE | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850404010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024647500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2006 | ||||||||
| LastUpdateDate: | 12/03/2012 | ||||||||
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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 | 207ZP0102X | 35236 | CT | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
ID Information
| ID | Type | State | Issuer | Description | 061344026 | 01 | CT | OXFORD HEALTH# | OTHER | 061344026 | 01 | CT | CIGNA# | OTHER | 500HBL160CT01 | 01 | CT | BLUE CARE FAMILY PLAN | OTHER | 061344026 | 01 | CT | UNITED HEALTHCARE# | OTHER | 061344026 | 01 | CT | AETNA/US HESALTHCARE# | OTHER | 500HBL160CT01 | 01 | CT | BC/BS# | OTHER | 744026 | 01 | CT | CONNECTICARE# | OTHER | C009155 | 01 | CT | CHAMPUS/TRICARE# | OTHER | 032344 | 01 | CT | HEALTHNET# | OTHER | 001352369 | 05 | CT | MEDICAID |