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Organization

GEORGIA NORTHSIDE EAR, NOSE AND THROAT, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WESLEY O. JAMES (REGIONAL CFO, TENET)
(404) 265-5009
Entity
Organization

Contact information

Practice address
1360 UPPER HEMBREE RD, SUITE 201, ROSWELL, GA 30076-1171
(770) 475-3361
(770) 664-4431
Mailing address
PO BOX 742566, ATLANTA, GA 30374-2105
(770) 475-3361
(770) 664-4431

Taxonomy

Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
207Y00000X
Otolaryngology Physician
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician

Other

Enumeration date
06/06/2013
Last updated
06/07/2016
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