Provider Demographics
NPI:1073620613
Name:OHBERG, JOHANN KURT (PA)
Entity Type:Individual
Prefix:MR
First Name:JOHANN
Middle Name:KURT
Last Name:OHBERG
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:2493 HAWTHORNE DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30345-2043
Mailing Address - Country:US
Mailing Address - Phone:770-939-5897
Mailing Address - Fax:
Practice Address - Street 1:1670 CLAIRMONT RD
Practice Address - Street 2:111-GI
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-4004
Practice Address - Country:US
Practice Address - Phone:404-321-6111
Practice Address - Fax:404-728-7746
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical