Provider Demographics
NPI:1033293535
Name:JOHNSTON, LISA H (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:H
Last Name:JOHNSTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2665 N DECATUR RD STE 450
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6146
Mailing Address - Country:US
Mailing Address - Phone:404-501-7555
Mailing Address - Fax:404-501-7550
Practice Address - Street 1:2665 N DECATUR RD STE 450
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6146
Practice Address - Country:US
Practice Address - Phone:404-501-7555
Practice Address - Fax:404-501-7550
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0432212084S0012X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA13BDCWSMedicare PIN
GAG68482Medicare UPIN