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NPI Code Detail

MEDICARE: LONNIE JOHNSON

MEDICARE:   LONNIE  JOHNSON
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
1332B00000XDurable Medical Equipment & Medical Supplies1001300TX

General Provider Information

NPI Number : 1659825198
Entity Type Code : Individual
Provider Name (Legal Business Name) : LONNIE JOHNSON
Provider Business Mailing Address
First Line : 3061 MILFORD CHASE SW
Second Line :
City : MARIETTA
State : GA
Zip : 30008-6882
Country : US
Telephone Number : 404-242-9881
Fax Number : 770-433-0682
Provider Business Practice Location Address
First Line : 1750 POWDER SPRINGS RD SW STE 190
Second Line :
City : MARIETTA
State : GA
Zip : 30064-4861
Country : US
Telephone Number : 404-242-9881
Fax Number : 770-433-0682
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/13/2016
Last Update Date : 08/13/2016

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Directions to “ LONNIE JOHNSON ” Practice Location

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