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Individual

TONJA T JOHNSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
715 PEACHTREE ST NE STE 100, ATLANTA, GA 30308-2179
(212) 369-6757
Mailing address
23110 STATE ROAD 54 # 367, LUTZ, FL 33549-6933
(813) 527-3612

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
ME105192
FL
2084P0800X
Psychiatry Physician
34400
AZ
2084P0800X
Psychiatry Physician
Primary
57670
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
34400
LICENSE
AZ
Enumeration date
02/26/2007
Last updated
07/20/2022
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