Organization
NORTHSIDE HOSPITAL, INC.
Active
Other names
Northside/Dunwoody Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JORGE J HERNANDEZ (VP/CHIEF COMPLIANCE OFFICER)
(404) 851-6378
Entity
Organization
Contact information
Practice address
4553 N SHALLOWFORD RD, STE. 60-C, ATLANTA, GA 30338-6408
(770) 455-1983
(770) 457-2823
Mailing address
1100 JOHNSON FERRY RD, CENTERPOINTE II, STE 920, ATLANTA, GA 30342-1709
(404) 851-6378
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
044-281
GA
Other
Enumeration date
03/28/2014
Last updated
03/28/2014
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