Provider Demographics
NPI:1235584079
Name:JOHNSTONE, ANDREW ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:ALAN
Last Name:JOHNSTONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3747 N FREMONT ST
Mailing Address - Street 2:APT 1
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-0388
Mailing Address - Country:US
Mailing Address - Phone:347-882-3030
Mailing Address - Fax:
Practice Address - Street 1:2000 CANAL ST # D&T
Practice Address - Street 2:2ND FL, SUITE 2720
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-3018
Practice Address - Country:US
Practice Address - Phone:347-882-3030
Practice Address - Fax:504-702-2500
Is Sole Proprietor?:No
Enumeration Date:2016-04-29
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036151886207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program