Johnson, Kathleen S
Johnson, Kathleen S is an individual health care provider with primary practice located at 1458 Church St Ste B , Decatur GA 30030-1672. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Johnson, Kathleen S can be contacted via phone (404) 501-6027.Contact Information
Primary practice address
1458 Church St Ste B
Decatur GA 30030-1672
Phone: (404) 501-6027
Fax: (404) 377-0550
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 054906 | Georgia |
Profile Details
| NPI number | 1104819689 |
|---|---|
| LBN Legal business name | Johnson, Kathleen S |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 30th, 2005 |
| Last updated | Oct 15th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104819689 | NPPES |
| Georgia | MEDICAID | 1048971676AB |
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