# NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** NORTHSIDE HOSPITAL, INC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1922397553
- **Legal business name:** NORTHSIDE HOSPITAL, INC
- **Authorized official:** AMY E FOUTS (CHIEF COMPLIANCE OFFICER)
- **Authorized official phone:** (404) 851-6968

## Contact information

- **Practice address:** 1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
- **Practice address phone:** (855) 709-4535
- **Mailing address:** 1000 JOHNSON FY RD NE, ATLANTA, GA 30342-1606
- **Mailing address phone:** (404) 851-8000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | GA | Yes |

## Other

- **Enumeration date:** 04/05/2011
- **Last updated:** 05/18/2026