Medical school: LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN SHREVEPORT
Graduated: 1991
Offers telehealth
NPI: 1629066584
Practice Locations (1)
NORTHSIDE PRIMARY CARE PROFESSIONAL SERVICES,LLC
875 JOHNSON FERRY RD NE, SUITE 200
ATLANTA, GA 303421418
4044971020
Source: CMS National Downloadable File, September 2026.