Mark J Johnson (NPI# 1407924608, PAC ID# 8628022969) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1407924608 |
| PAC ID by PECOS | 8628022969 |
| Professional Enrollment ID | I20050309000476 |
| Full Name | Mark J Johnson |
| Organization Legal Name | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| Address |
2240 Fountain Dr Snellville GA 30078-2919 |
| Phone Number | 4043791105 |
| Gender | M |
| Credential | MD |
| Medical School | OHIO STATE UNIVERSITY COLLEGE OF MEDICINE |
| Graduation Year | 1988 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 6204829013 |
| Number of Group Practice Members | 600 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 | 4045054012 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| 2525 Cumberland Pkwy Se, Atlanta, GA 30339-3915 | 7704314235 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| 3495 Piedmont Rd Ne, Building Nine, Atlanta, GA 30305-1736 | 4043647206 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| 3650 Steve Reynolds Blvd, Duluth, GA 30096-4506 | 7709316026 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 | 7706033685 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| 2470 Mount Zion Pkwy, Bldg 200, Jonesboro, GA 30236-2500 | 7705279031 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| 750 Townpark Ln Nw, Kennesaw, GA 30144-5579 | 7705145405 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| 1125 Towne Ctr Village Dr, Mcdonough, GA 30253-5970 | 6785836610 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| 205 Newnan Crossing Byp, Newnan, GA 30265-1063 | 4043796148 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| 2240 Fountain Dr, Snellville, GA 30078-2919 | 4043791105 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| 200 Crescent Ctr Pkwy, Tucker, GA 30084-7047 | 4043650966 | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| Organization Legal Name | THE SOUTHEAST PERMANENTE MEDICAL GROUP |
| Physicians | 720 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sapna Ashok Patel | Otolaryngology | The Southeast Permanente Medical Group | 2470 Mount Zion Pkwy, Bldg 200, Jonesboro, GA 30236-2500 |
| Gloria Eberechukwu Okoye | Nurse Practitioner | The Southeast Permanente Medical Group | 3640 Tramore Pointe Pkwy, Austell, GA 30106-6825 |
| Joan Mary Gopin | Hospitalist | The Southeast Permanente Medical Group | 2525 Cumberland Pkwy Se, Atlanta, GA 30339-3915 |
| Sandra Nicole Jackson-dent | Family Medicine | The Southeast Permanente Medical Group | 2240 Fountain Dr, Snellville, GA 30078-2919 |
| Emily K Deschler | Ophthalmology | The Southeast Permanente Medical Group | 2400 Mount Zion Pkwy, Jonesboro, GA 30236-2500 |
| Vicki L Yates | Certified Nurse Midwife (cnm) | The Southeast Permanente Medical Group | 6875 Douglas Blvd, Suite A, Douglasville, GA 30135-7155 |
| Lisa Michaels | Podiatry | The Southeast Permanente Medical Group | 200 Crescent Ctr Pkwy, Tucker, GA 30084-7047 |
| Seema Panduranga Kini | Dermatology | The Southeast Permanente Medical Group | 1435 Broadmoor Blvd, Buford, GA 30518-5408 |
| Modesta Tako | Family Medicine | The Southeast Permanente Medical Group | 1175 Cascade Pkwy Sw, Atlanta, GA 30311-3090 |
| Samir Patel | Internal Medicine | The Southeast Permanente Medical Group | 205 Newnan Crossing Byp, Newnan, GA 30265-1063 |
| Street Address |
2240 FOUNTAIN DR |
| City | SNELLVILLE |
| State | GA |
| Zip | 30078-2919 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Sandra Nicole Jackson-dent | Family Medicine | The Southeast Permanente Medical Group | 2240 Fountain Dr, Snellville, GA 30078-2919 |
| Hope J Mitchell | Family Medicine | The Southeast Permanente Medical Group | 2240 Fountain Dr, Snellville, GA 30078-2919 |
| Kate Koplan | Internal Medicine | The Southeast Permanente Medical Group | 2240 Fountain Dr, Snellville, GA 30078-2919 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ashley Ann Mire | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Ramanjaneyulu V Dronavalli | Internal Medicine | 2138 Scenic N Hwy A, Snellville, GA 30078 | |
| Jody Meek | Anesthesiology Assistant | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Brittany E Bradley | Certified Registered Nurse Anesthetist (crna) | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Keith Alan Housman | Anesthesiology | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Thien D Quach | Anesthesiology | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Benjamin Lee Hicks | Anesthesiology Assistant | Premier Anesthesia of Georgia LLC | 1700 Medical Ctr Way, Snellville, GA 30078 |
| Geetha Jonnala | Rheumatology | 1567 Janmar Rd, Suite 100, Snellville, GA 30078-0308 | |
| Oyinkansola Akinmade | Physical Therapy | Caretherapy, LLC | 1567 Janmar Rd, Snellville, GA 30078-0309 |
| Allison L Guisasola | Occupational Therapy | Caretherapy, LLC | 1567 Janmar Rd, Snellville, GA 30078-0309 |
| Find all physicians in zip 30078 | |||
| City | SNELLVILLE |
| Zip Code | 30078 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | SNELLVILLE + DIAGNOSTIC RADIOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.