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General NPI Number Information
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NPI Number | 1942450531
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Entity Type | Organization
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Legal Business Name | R. NEIL JOHNSTON, MD, LLC
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Dates
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Enumeration Date | 09/19/2008
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Last Update Date | 06/24/2010
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Provider Practice Location Address
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Address Line | 544 MEDLOCK RD
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City | DECATUR
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State | GA
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Zip | 30030-1515
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Country | US
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Telephone | 404-378-0330
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Fax | 404-378-2191
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Provider Business Mailing Address
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Address Line | PO BOX 666
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City | DECATUR
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State | GA
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Zip | 30031-0666
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Country | US
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Telephone | 404-931-8330
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Fax | 404-378-2191
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | R NEIL JOHNSTON
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Credential | MD
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Telephone | 404-378-0330
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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 | 040428
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License Number State | GA
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