Organization
NORTHSIDE ORTHOPEDIC PROFESSIONAL SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY E FOUTS (CHIEF COMPLIANCE OFFICER)
(404) 851-6968
Entity
Organization
Contact information
Practice address
1000 JOHNSON FY RD NE, ATLANTA, GA 30342-1606
(404) 851-8000
Mailing address
1001 SUMMIT BLVD STE 1000, BROOKHAVEN, GA 30319-6415
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Enumeration date
05/14/2026
Last updated
05/14/2026
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