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Organization

NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES, LLC

Active
Parent organization
NORTHSIDE PRIMARY CARE PROFESIONAL SERVICES, LLC
Other names
Northside Dawson Urgent Care
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHSIDE PRIMARY CARE PROFESIONAL SERVICES, LLC
Authorized official
JORGE J. HERNANDEZ (VP-ADMIN, CCO)
(404) 851-6378
Entity
Organization

Contact information

Practice address
81 NORTHSIDE DAWSON DRIVE, DAWSONVILLE, GA 30534-7166
(855) 709-4535
Mailing address
1100 JOHNSON FERRY RD, SUITE 780, ATLANTA, GA 30342-1709
(404) 851-6378

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
GA
261QU0200X
Urgent Care Clinic/Center
Primary
GA

Other

Enumeration date
08/07/2013
Last updated
01/11/2023
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