# WEST ATLANTA INTERNAL MEDICINE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356689806
- **Authorized official:** DR. JOHN ALEXANDER JOHNSON MD (MEDICAL DIRECTOR/OWNER)
- **Authorized official phone:** (770) 942-6903

## Contact information

- **Practice address:** 6128 PRESTLEY MILL RD, SUITE G, DOUGLASVILLE, GA 30134-5621
- **Practice address phone:** (770) 942-6903
- **Practice address fax:** (770) 942-6908
- **Mailing address:** 6128 PRESTLEY MILL RD, SUITE G, DOUGLASVILLE, GA 30134-5621
- **Mailing address phone:** (770) 942-6903
- **Mailing address fax:** (770) 942-6908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | 046866 | GA | Yes |

## Other

- **Enumeration date:** 01/17/2013
- **Last updated:** 01/28/2013