1235584079 NPI number — DR. ANDREW ALAN JOHNSTONE M.D.

Table of content: DR. ANDREW ALAN JOHNSTONE M.D. (NPI 1235584079)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235584079 NPI number — DR. ANDREW ALAN JOHNSTONE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNSTONE
Provider First Name:
ANDREW
Provider Middle Name:
ALAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235584079
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/23/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3747 N FREMONT ST
Provider Second Line Business Mailing Address:
APT 1
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60613-0388
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-882-3030
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2000 CANAL ST # D&T
Provider Second Line Business Practice Location Address:
2ND FL, SUITE 2720
Provider Business Practice Location Address City Name:
NEW ORLEANS
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70112-3018
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
347-882-3030
Provider Business Practice Location Address Fax Number:
504-702-2500
Provider Enumeration Date:
04/29/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  036151886 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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