Organization
NORTHSIDE PEDIATRICS & ADOLESCENT MEDICINE PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VICKI M TITTLE (PRACTICE ADMINSTRATOR)
(404) 705-8990
Entity
Organization
Contact information
Practice address
1140 HAMMOND DRIVE, SUITE E5250, ATLANTA, GA 30328
(404) 256-2688
(404) 256-1820
Mailing address
333 SANDY SPRINGS CIRCLE, SUITE 207, ATLANTA, GA 30328-3834
(404) 705-8990
(404) 705-9984
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
03/30/2007
Last updated
08/22/2020
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