Individual
DR. MARK JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1968 PEACHTREE RD NW, 77 BUILDING 5TH FLOOR, ATLANTA, GA 30309-1281
(404) 605-4600
Mailing address
PO BOX 102321, ATLANTA, GA 30368-2321
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
055843
GA
208600000X
Surgery Physician
Primary
ME124207
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
015133000
—
FL
Enumeration date
02/15/2007
Last updated
07/10/2015
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