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Organization
NORTHSIDE PEDIATRICS PC
Active
Organization
NORTHSIDE PEDIATRICS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMETT R BERRY MD (PRESIDENT)
(478) 477-4044
Entity
Organization
Contact information
Practice address
3888 NORTHSIDE DR, MACON, GA 31210-2417
(478) 477-4044
(478) 477-7076
Mailing address
3888 NORTHSIDE DR, MACON, GA 31210-2417
(478) 477-4044
(478) 477-7076
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
NULL
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
—
—
Other
Enumeration date
10/24/2018
Last updated
10/24/2018
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