# STEPHENS COUNTY HOSPITAL PHYSICIAN GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** STEPHENS COUNTY HOSPITAL PHYSICIAN GROUP, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1114643251
- **Legal business name:** STEPHENS COUNTY HOSPITAL PHYSICIAN GROUP, LLC
- **Authorized official:** THOMAS LOSKOSKI (CEO)
- **Authorized official phone:** (706) 282-5841

## Contact information

- **Practice address:** 189 BO JAMES ST STE 105, CLAYTON, GA 30525-6199
- **Practice address phone:** (706) 282-4200
- **Mailing address:** 189 BO JAMES ST STE 105, CLAYTON, GA 30525-6199

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/19/2022
- **Last updated:** 10/19/2022