Medical school: UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Graduated: 1989
NPI: 1285600064
Practice Locations (3)
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
NORTHSIDE SURGICAL PROFESSIONAL SERVICES LLC
2000 HOWARD FARM DR, SUITE 305
CUMMING, GA 300416075
4048474180
Source: CMS National Downloadable File, September 2026.