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Organization
MIDWESTERN ADVANCED ORTHOPAEDICS AND SPORTS MEDICINE INC
Active
Organization
MIDWESTERN ADVANCED ORTHOPAEDICS AND SPORTS MEDICINE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS TOUSSAINT JOHNSON PA-C (OWNER)
(404) 296-5005
Entity
Organization
Contact information
Practice address
2801 N DECATUR RD, SUITE 200, DECATUR, GA 30033-5949
(404) 296-5005
(404) 296-2070
Mailing address
433 HIGHLAND AVE NE, APT 1407, ATLANTA, GA 30312-1391
(404) 296-5005
(404) 296-2070
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
6115
GA
Other
Enumeration date
08/19/2011
Last updated
08/19/2011
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