MEDICARE: DR. JAMLIK OMARI JOHNSON 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	2085R0202X	Diagnostic Radiology Physician	054905	GA
2	2085R0202X	Diagnostic Radiology Physician	036113352	IL

General Provider Information

NPI Number	:	1528060449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMLIK OMARI JOHNSON M.D.

Provider Business Mailing Address
First Line	:	550 PEACHTREE ST NE
Second Line	:	EMORY UNIVERSITY(EUHM)
City	:	ATLANTA
State	:	GA
Zip	:	30308-2212
Country	:	US
Telephone Number	:	404-686-5612
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 PEACHTREE ST NE
Second Line	:	EMORY UNIVERSITY(EUHM)
City	:	ATLANTA
State	:	GA
Zip	:	30308-2212
Country	:	US
Telephone Number	:	404-686-5612
Fax Number	:

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

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	12/16/2025

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