Dr Derrick Thor Johnston, DDS is a
Dentist based in Bisbee, Arizona. Dr Derrick Thor Johnston is licensed to practice in Arizona (license number 2689) and his current practice location is
2 Naco Rd, Bisbee, Arizona. He can be reached at his office (for appointments etc.) via phone at
(520) 432-5371.
NPI number for Dr Derrick Thor Johnston is 1578625091 and his current mailing address is 2 Naco Rd, P.o. Box 1898, Bisbee, Arizona. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1578625091.
Healthcare Provider's Profile
| Full Name | Dr Derrick Thor Johnston |
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| Gender | Male |
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| Speciality | Dentist |
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| Location | 2 Naco Rd, Bisbee, Arizona |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1578625091
- Provider Enumeration Date: 12/14/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Derrick Thor Johnston such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1578625091 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 2689 (Arizona) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Derrick Thor Johnston is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Derrick Thor Johnston, DDS
2 Naco Rd, P.o. Box 1898,
Bisbee, AZ 85603
Ph: (520) 432-5371 | Dr Derrick Thor Johnston, DDS
2 Naco Rd,
Bisbee, AZ 85603
Ph: (520) 432-5371 |
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