# ST. MARY'S MEDICAL GROUP, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clear Creek OB/GYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437407053
- **Authorized official:** BRITTAINY HORNE (PRESIDENT)
- **Authorized official phone:** (706) 389-3940

## Contact information

- **Practice address:** 355 CLEAR CREEK PKWY STE 1003, LAVONIA, GA 30553-4271
- **Practice address phone:** (706) 356-0780
- **Practice address fax:** (706) 356-0781
- **Mailing address:** PO BOX 48089, ATHENS, GA 30604-8089
- **Mailing address phone:** (706) 389-3740
- **Mailing address fax:** (706) 389-3951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/29/2012
- **Last updated:** 11/02/2022