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General NPI Number Information
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NPI Number | 1316112188
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Entity Type | Organization
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Legal Business Name | DEBORA STOREY JOHNSON, MD PC
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Dates
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Enumeration Date | 04/23/2008
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Last Update Date | 04/23/2008
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Provider Practice Location Address
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Address Line | 950 DANNON VW SW SUITE 4101
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City | ATLANTA
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State | GA
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Zip | 30331-2160
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Country | US
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Telephone | 404-699-9600
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Fax | 404-696-7100
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Provider Business Mailing Address
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Address Line | 950 DANNON VW SW SUITE 4101
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City | ATLANTA
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State | GA
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Zip | 30331-2160
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Country | US
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Telephone | 404-699-9600
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Fax | 404-696-7100
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Authorized Official
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Title or Position | PRESIDENT AND CEO
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Name | DR. DEBORA STOREY JOHNSON
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Credential | M.D.
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Telephone | 404-699-9600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 043071
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 043071
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License Number State | GA
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