Organization
NORTHSIDE SEPC PROFESSIONAL SERVICES, LLC
Active
Organization
NORTHSIDE SEPC PROFESSIONAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JORGE J HERNANDEZ (VP ADMIN. SRVS/CCO)
(404) 851-6378
Entity
Organization
Contact information
Practice address
1000 JOHNSON FY RD NE, ATLANTA, GA 30342-1606
(404) 851-8000
Mailing address
1100 JOHNSON FY RD NE STE 780, ATLANTA, GA 30342-1743
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/27/2018
Last updated
06/03/2025
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