Organization
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
Active
Parent organization
NORTHSIDE HOSPITAL INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHSIDE HOSPITAL INC
Authorized official
JORGE J HERNANDEZ (VP OF ADMIN SERVICES AND CCO)
(404) 851-6378
Entity
Organization
Contact information
Practice address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(855) 709-4535
Mailing address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(404) 851-8000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193400000X
TAXONOMY
—
Enumeration date
04/05/2011
Last updated
06/02/2025
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