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Individual

DR. KELLEY MARSHALL JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7795 LANDOWNE DR, ATLANTA, GA 30350-1063
(770) 730-8535
(770) 730-8535
Mailing address
CHILDREN'S HEALTHCARE OF ATLANTA, 2220 NORTH DRUID HILLS ROAD NE-DEPARTMENT OF RADIOLOGY, ATLANTA, GA 30329
(404) 785-6532
(770) 730-8535

Taxonomy

Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
048372
GA
2085P0229X
Pediatric Radiology Physician
Primary
48372
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000568993
ANTHEM/NORTON
KY
01
000023033O
HUMANA/NORTON
KY
05
000852893
GA
01
00533044
MEDICARE
KY
01
096946
SIHO/NORTON
KY
05
200928350
IN
01
50019563
PASSPORT/NORTON
KY
01
7100044200
KY MEDICAID-NORTON
KY
Enumeration date
02/13/2006
Last updated
04/21/2025
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