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

John In-Taek Song, MD

Individual provider Otolaryngology Physician · NPI 1093808446

John In-Taek Song, MD is an Otolaryngology in Atlanta, Georgia. Graduated from New York University School of Medicine in 1991, 35 years ago. Practices with Northside Surgical Professional Services LLC, a 368-clinician group and accepts Medicare assignment. Licensed in Colorado and Georgia.

Years since qualifying
35
Trained at
New York University School of Medicine
Licensed in
CO, GA
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

960 Johnson Ferry Rd Ste 335
Atlanta, GA 30342-1625
Phone: (404) 257-1482
Fax: (404) 257-1483
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Otolaryngology Physician (primary) Taxonomy 207Y00000X · Licence 87662 (GA)
Otolaryngology Physician Taxonomy 207Y00000X · Licence 40893 (CO)

Record details

NPI number1093808446
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 30, 2006
Last updated in NPPESJanuary 12, 2021
Certification dateJanuary 12, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOTOLARYNGOLOGY
Medical schoolNEW YORK UNIVERSITY SCHOOL OF MEDICINE
Graduated 1991 (35 years in practice)
Group practice Northside Surgical Professional Services Llc — 368 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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