Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0400X | Neurologist | 043221 | GA |
NPI | 1033293535 |
---|---|
Provider Name | Dr. Lisa H Johnston |
First Address | Atlanta, GA 30342-1775 |
Second Address | Atlanta, GA 30342-1775 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 03/05/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G68482 | (02) | GA |