Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 73865 | GA |
N | 111NI0900X | Internist | 73865 | GA |
NPI | 1003175431 |
---|---|
Provider Name | Dr. Tianna E. Johnson |
First Address | Atlanta, GA 30309-1613 |
Second Address | Atlanta, GA 30309-1613 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2012 |
Last Update Date | 22/03/2017 |