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Contact Information

NORTHSIDE EAR, NOSE & THROAT, PC
1360 UPPER HEMBREE RD
201
ROSWELL, GA30076-1171
 Phone: 770-475-3361
 Fax: 770-664-4431
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Allergy & Immunology

207K00000X 03 Physician/Allergy/ Immunology
 

Plastic Surgery within the Head & Neck

207YX0007X 04 Physician/Otolaryngology
Indicates primary specialty

NPI Profile & details for NORTHSIDE EAR NOSE THROAT PC · (Female)

NPI Number 1013071273
Status Active
Credentials
Entity Individual
Enumeration date 12/21/2006
Last updated 09/11/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 036368
  • GA License # 059383
  • GA License # 57545
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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