St. Mary's Medical Group, Inc.

NPI #1528516929 in Lavonia, Georgia

Provider Information

NPI Number: 1528516929
Entity Type: Organization
Organization Name: St. Mary's Medical Group, Inc.
Primary Specialty: Surgery
Enumeration Date: Sep 14, 2016
Last Updated: Apr 2, 2018

Practice Location

Address: 355 CLEAR CREEK PKWY
Address 2: SUITE 1008
City: Lavonia
State: Georgia
ZIP Code: 30553-4174
Phone: (706) 356-6894

Authorized Official

Name: D. MONTEZ CARTER
Title: PRESIDENT & CEO
Phone: (706) 389-3930

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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