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Organization
NORTHSIDE WGG LLC
Active
Organization
NORTHSIDE WGG LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY E FOUTS (CHIEF COMPLIANCE OFFICER)
(404) 851-6968
Entity
Organization
Contact information
Practice address
595 HURRICANE SHOALS RD, BLDG 2, STE 110, LAWRENCEVILLE, GA 30046
(770) 979-4700
Mailing address
1000 JOHNSON FY RD NE, SANDY SPRINGS, GA 30342-1606
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
07/14/2025
Last updated
07/01/2026
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