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NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC NPI 1356630990


NPI Information

NPI: 1356630990
Provider Name: NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
Classification: Surgery - 208600000X
Entity Type: Organization

CLIA Number: 11D0970390

Address:
1000 JOHNSON FERRY RD NE
ATLANTA, GA
ZIP 30342
Phone: (404) 851-8000
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NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC is a surgery in Atlanta, GA. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC NPI is 1356630990. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1000 JOHNSON FERRY RD NE
ATLANTA, GA
ZIP 30342-606
Phone: (404) 851-8000

The provider's authorized official is Jorge J Hernandez .
The authorized official title is Vp Of Admin Services And Cco and has the following contact phone number (404) 851-6378.

The CLIA number assigned to this NPI record is 11D0970390 - hospital with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/5/2011 and was last updated on 4/5/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1193400000XOTHERTAXONOMY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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