Organization
NORTHSIDE BARIATRIC SURGERY CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFANY BOSTWICK (OFFICE ADMINISTRATOR)
(404) 252-2220
Entity
Organization
Contact information
Practice address
960 JOHNSON FERRY RD NE, SUITE 228, ATLANTA, GA 30342-1631
(404) 252-2220
(404) 252-4530
Mailing address
960 JOHNSON FERRY RD NE, SUITE 228, ATLANTA, GA 30342-1631
(404) 252-2220
(404) 252-4530
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
37604
GA
Other
Enumeration date
02/09/2007
Last updated
11/23/2020
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