Provider Demographics
NPI:1649260415
Name:JOHNSON, ROBERT PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:PAUL
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:954 GATEWOOD RD NE
Mailing Address - Street 2:YERKES/EMORY UNIVERSITY
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-4208
Mailing Address - Country:US
Mailing Address - Phone:404-727-7707
Mailing Address - Fax:404-727-0623
Practice Address - Street 1:1364 CLIFTON RD NE
Practice Address - Street 2:EMORY UNIVERSITY HOSPITAL
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1059
Practice Address - Country:US
Practice Address - Phone:404-712-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2014-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA59359207R00000X, 207RI0200X
GA72334207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3066461Medicaid
MA724123OtherTUFTS HEALTH PLAN
MAJ09576OtherBCBS MA
MA724123OtherTUFTS HEALTH PLAN
E51783Medicare UPIN