# NORTHSIDE WOMENS GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** NORTHSIDE WGG
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275380701
- **Authorized official:** AMY E FOUTS (CHIEF COMPLIANCE OFFICER)
- **Authorized official phone:** (404) 851-6968

## Contact information

- **Practice address:** 595 HURRICANE SHOALS RD NW STE 110, LAWRENCEVILLE, GA 30046-8761
- **Practice address phone:** (770) 979-4700
- **Mailing address:** 1000 JOHNSON FY RD NE, ATLANTA, GA 30342-1606

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/02/2024
- **Last updated:** 05/27/2026