Individual
DR. KATHLEEN S JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1458 CHURCH ST STE B, DECATUR, GA 30030-1672
(404) 501-6027
(404) 377-0550
Mailing address
1458 CHURCH ST STE B, DECATUR, GA 30030-1672
(404) 508-5012
(404) 508-5560
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
054906
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1048971676AB
—
GA
Enumeration date
08/30/2005
Last updated
10/15/2021
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