Organization
SOUTHSIDE ASSOCIATES OB/GYN, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES MCKINLEY FREEMONT SR. M.D. (PRESIDENT)
(404) 768-3487
Entity
Organization
Contact information
Practice address
1136 CLEVELAND AVE, SUITE 208, EAST POINT, GA 30344-3618
(404) 768-3487
(404) 768-1051
Mailing address
1136 CLEVELAND AVE, SUITE 208, EAST POINT, GA 30344-3618
(404) 768-3487
(404) 768-1051
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
016343
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00117752A
—
GA
05
—
00117752F
—
GA
Enumeration date
09/25/2006
Last updated
05/14/2009
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