Northside Pediatrics & Adolescent Medicine PC

NPI #1417077884 in Atlanta, Georgia

Provider Information

NPI Number: 1417077884
Entity Type: Organization
Organization Name: Northside Pediatrics & Adolescent Medicine PC
Primary Specialty: Pediatrics
Enumeration Date: Mar 30, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 1140 HAMMOND DRIVE
Address 2: SUITE E5250
City: Atlanta
State: Georgia
ZIP Code: 30328
Phone: (404) 256-2688

Authorized Official

Name: MRS. VICKI M TITTLE
Title: PRACTICE ADMINSTRATOR
Phone: (404) 705-8990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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