# NORTHSIDE WOMEN'S SPECIALIST, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275689309
- **Authorized official:** KEITH GRONE (REIMBURSEMENT MANAGER)
- **Authorized official phone:** (404) 255-2057

## Contact information

- **Practice address:** 980 JOHNSON FERRY RD NE, SUITE 620, ATLANTA, GA 30342-1626
- **Practice address phone:** (404) 255-2057
- **Practice address fax:** (404) 256-4238
- **Mailing address:** 980 JOHNSON FERRY RD NE, SUITE 620, ATLANTA, GA 30342-1626
- **Mailing address phone:** (404) 255-2057
- **Mailing address fax:** (404) 256-4238

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | NULL | — |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | — | — |

## Other

- **Enumeration date:** 01/25/2007
- **Last updated:** 09/11/2025