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Organization

NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC

Active
Parent organization
NORTHSIDE HOSPITAL, INC
Organization subpart
Yes

Provider details

NPI number
Legal business name
NORTHSIDE HOSPITAL, INC
Authorized official
JORGE J HERNANDEZ (VP OF ADMIN SERVCES AND CCO)
(404) 851-6378
Entity
Organization

Contact information

Practice address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(855) 709-4535
Mailing address
1000 JOHNSON FERRY RD NE, ATLANTA, GA 30342-1606
(404) 851-8000

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
193400000X
TAXONOMY
Enumeration date
04/05/2011
Last updated
06/02/2025
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