R. Neil Johnston, Md, Llc | |
544 Medlock Rd Decatur GA 30030-1515 | |
(404) 378-0330 | |
(404) 378-2191 |
Full Name | R. Neil Johnston, Md, Llc |
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Speciality | Psychiatry & Neurology |
Location | 544 Medlock Rd, Decatur, Georgia |
Authorized Official Name and Position | R Neil Johnston (CEO/PRESIDENT) |
Authorized Official Contact | 4043780330 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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R. Neil Johnston, Md, Llc Po Box 666 Decatur GA 30031-0666 Ph: (404) 931-8330 | R. Neil Johnston, Md, Llc 544 Medlock Rd Decatur GA 30030-1515 Ph: (404) 378-0330 |
NPI Number | 1942450531 |
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Provider Enumeration Date | 09/19/2008 |
Last Update Date | 06/24/2010 |
Medicare PECOS PAC ID | 8921163312 |
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Medicare Enrollment ID | O20090219000608 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942450531 | NPI | - | NPPES |
000763188E | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 040428 (Georgia) | Primary |
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