NORTHSIDE WOMEN'S SPECIALIST P.C. NPI 1275689309

NPI Details

NORTHSIDE WOMEN'S SPECIALIST, P.C. is an obstetrics gynecology in Atlanta, GA. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. NORTHSIDE WOMEN'S SPECIALIST, P.C. NPI is 1275689309. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

980 JOHNSON FERRY RD NE
SUITE 620
ATLANTA, GA
ZIP 30342-626
Phone: (404) 255-2057
Fax: (404) 256-4238

The provider's authorized official is Keith Grone .
The authorized official title is Reimbursement Manager and has the following contact phone number (404) 255-2057.

The CLIA number assigned to this NPI record is 11D2308323 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/25/2007 and was last updated on 9/11/2025.

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: