Provider Demographics
NPI:1821032673
Name:JOHNSTON NEUROLOGY, PA
Entity Type:Organization
Organization Name:JOHNSTON NEUROLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AJMAL
Authorized Official - Middle Name:M
Authorized Official - Last Name:GILANI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:866-457-5293
Mailing Address - Street 1:PO BOX 16127
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-6127
Mailing Address - Country:US
Mailing Address - Phone:866-457-5293
Mailing Address - Fax:919-967-6647
Practice Address - Street 1:11618 US HIGHWAY 70 W
Practice Address - Street 2:
Practice Address - City:CLAYTON
Practice Address - State:NC
Practice Address - Zip Code:27520-2275
Practice Address - Country:US
Practice Address - Phone:919-550-2501
Practice Address - Fax:919-967-6647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC131T0OtherBCBS NC
NC5904155Medicaid
NC131T0OtherBCBS NC