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General NPI Number Information
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NPI Number | 1932237195
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Entity Type | Organization
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Legal Business Name | NORTHSIDE SURGERY CENTER, INC
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 10/21/2011
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Provider Practice Location Address
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Address Line | 5505 PEACHTREE DUNWOODY RD NE SUITE 415
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City | ATLANTA
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State | GA
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Zip | 30342-1705
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Country | US
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Telephone | 404-843-0090
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Fax | 404-843-1008
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Provider Business Mailing Address
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Address Line | PO BOX 720091
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City | SANDY SPRINGS
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State | GA
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Zip | 30358-2091
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Country | US
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Telephone | 404-843-0090
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Fax | 404-843-1008
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HEATHER H MORSE
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Credential |
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Telephone | 404-843-0090
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 060 058
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License Number State | GA
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