Healthcare Provider Details

I. General information

NPI: 1992758221
Provider Name (Legal Business Name): PAUL SCOTT JOHNSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 JOHNSON FERRY RD NE
ATLANTA GA
30342-1605
US

IV. Provider business mailing address

945 BIG HORN CIR
ALPHARETTA GA
30022-4793
US

V. Phone/Fax

Practice location:
  • Phone: 678-344-1960
  • Fax: 404-785-4969
Mailing address:
  • Phone: 678-344-1960
  • Fax: 678-344-1960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PP0204X
TaxonomyPediatric Emergency Medicine (Emergency Medicine) Physician
License Number046132
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: