Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Northlake Internal Medicine

Organization Medical Specialty Clinic/Center · NPI 1710286414

Northlake Internal Medicine is a Medical Specialty Clinic/Center in Tucker, Georgia. Licensed in Georgia. Registered with an NPI since 2011.

Licensed in
GA
In the registry since
2011

Practice location Address checks out

2175 Northlake Pkwy St 142 Bldg 4
Tucker, GA 30084-4163
Phone: (770) 496-2929
Fax: (770) 496-2930
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Specialty Clinic/Center (primary) Taxonomy 261QM2500X · Licence 017369 (GA)

Record details

NPI number1710286414
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official John Budell — Owner · (770) 496-2929
NPI enumeratedMarch 21, 2011
Last updated in NPPESMarch 21, 2011
Mailing address2175 Northlake Pkwy, St 142,Bldg 4, Tucker, GA 30084-4163

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