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SOUTHSIDE ASSOCIATES OB/GYN INC NPI 1366542490


NPI Information

NPI: 1366542490
Provider Name: SOUTHSIDE ASSOCIATES OB/GYN, INC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1136 CLEVELAND AVE
SUITE 208
EAST POINT, GA
ZIP 30344
Phone: (404) 768-3487
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SOUTHSIDE ASSOCIATES OB/GYN, INC is a specialist in East Point, GA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SOUTHSIDE ASSOCIATES OB/GYN, INC NPI is 1366542490. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1136 CLEVELAND AVE
SUITE 208
EAST POINT, GA
ZIP 30344-618
Phone: (404) 768-3487
Fax: (404) 768-1051

The provider's authorized official is James Mckinley Freemont .
The authorized official title is President and has the following contact phone number (404) 768-3487.

The enumeration date for this NPI number is 9/25/2006 and was last updated on 5/14/2009.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1174400000XSpecialist016343GEORGIAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100117752AMEDICAIDGEORGIA
2D39901MEDICARE UPINGEORGIA
300117752FMEDICAIDGEORGIA

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.