Provider Demographics
NPI:1124197686
Name:JOHNS, THOMAS BRADFORD (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BRADFORD
Last Name:JOHNS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2150 PEACHFORD ROAD
Mailing Address - Street 2:SUITE R
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30338
Mailing Address - Country:US
Mailing Address - Phone:770-455-0261
Mailing Address - Fax:678-209-5300
Practice Address - Street 1:6100 LAKE FORREST DR
Practice Address - Street 2:STE 450
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3837
Practice Address - Country:US
Practice Address - Phone:770-766-7006
Practice Address - Fax:678-713-2555
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0438332084P0800X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000810928CMedicaid
GA26BDHKDMedicare UPIN
26BDHKDMedicare ID - Type Unspecified
G83339Medicare UPIN