SOUTHSIDE FAMILY PRACTICE NPI 1720385925

NPI Information

  • NPI: 1720385925
  • Provider Name: SOUTHSIDE FAMILY PRACTICE
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 11D2043009
  • Address: 5898 JONESBORO RD
    MORROW, GA
    ZIP 30260
  • Phone: (770) 629-5410

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NPI Details

SOUTHSIDE FAMILY PRACTICE is a family nurse practitioner in Morrow, GA. SOUTHSIDE FAMILY PRACTICE NPI is 1720385925. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5898 JONESBORO RD
MORROW, GA
ZIP 30260
Phone: (770) 629-5410
Fax: (678) 519-2580

The provider's authorized official is Evelyn Onunka .
The authorized official title is Np-c and has the following contact phone number (770) 629-5410.

The CLIA number assigned to this NPI record is 11D2043009 - practitioner other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/24/2011 and was last updated on 2/24/2011.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyRN094938NPGEORGIAYes

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: 11/21/2025

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