Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated: 1980
NPI: 1043279003
Practice Locations (2)
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
1000 JOHNSON FERRY NE
ATLANTA, GA 303421606
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
1000 JOHNSON FERRY RD NE
ATLANTA, GA 303421606
4048518000
Source: CMS National Downloadable File, September 2026.