Provider Demographics
NPI:1093074098
Name:HUSKEY, JOHNATAN LEE (CSA)
Entity Type:Individual
Prefix:
First Name:JOHNATAN
Middle Name:LEE
Last Name:HUSKEY
Suffix:
Gender:M
Credentials:CSA
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Mailing Address - Street 1:3495 PIEDMONT ROAD, NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:404-504-5678
Mailing Address - Fax:770-840-7464
Practice Address - Street 1:2004 PEACHTREE ROAD, NW, SUITE 100
Practice Address - Street 2:KASIER PERMANENTE AT PIEDMONT HOSPITAL
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:678-691-6529
Practice Address - Fax:770-840-7464
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2017-05-03
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant