MEDICARE: DR. LISA H JOHNSTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084S0012X	Sleep Medicine (Psychiatry & Neurology) Physician	043221	GA
2	2084N0400X	Neurology Physician	043221	GA

General Provider Information

NPI Number	:	1033293535
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LISA H JOHNSTON M.D.

Provider Business Mailing Address
First Line	:	2665 N DECATUR RD STE 450
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-6146
Country	:	US
Telephone Number	:	404-501-7555
Fax Number	:	404-501-7550

Provider Business Practice Location Address
First Line	:	2665 N DECATUR RD STE 450
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-6146
Country	:	US
Telephone Number	:	404-501-7555
Fax Number	:	404-501-7550

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	10/16/2024

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