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ST. MARY'S MEDICAL GROUP INC NPI 1538393301


NPI Information

NPI: 1538393301
Provider Name: ST. MARY'S MEDICAL GROUP, INC

Other Name: ST. MARY'S NEUROLOGICAL SPECIALISTS

Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

CLIA Number: 11D2012746

Address:
1230 BAXTER ST
ATHENS, GA
ZIP 30606
Phone: (706) 310-1859
Get Directions

ST. MARY'S MEDICAL GROUP, INC is a neurology psychiatry neurology in Athens, GA. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. ST. MARY'S MEDICAL GROUP, INC NPI is 1538393301. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is St. Mary's Neurological Specialists.

The provider's business location address is:

1230 BAXTER ST
ATHENS, GA
ZIP 30606-712
Phone: (706) 310-1859
Fax: (706) 310-9902

The provider's authorized official is D. Montez Carter .
The authorized official title is President & Ceo and has the following contact phone number (706) 389-3930.

The CLIA number assigned to this NPI record is 11D2012746 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/8/2009 and was last updated on 3/12/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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