Organization
STEPHENS COUNTY HOSPITAL PHYSICIAN GROUP, LLC
Active
Parent organization
STEPHENS COUNTY HOSPITAL PHYSICIAN GROUP, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
STEPHENS COUNTY HOSPITAL PHYSICIAN GROUP, LLC
Authorized official
THOMAS LOSKOSKI (CEO)
(706) 282-5841
Entity
Organization
Contact information
Practice address
189 BO JAMES ST STE 105, CLAYTON, GA 30525-6199
(706) 282-4200
Mailing address
189 BO JAMES ST STE 105, CLAYTON, GA 30525-6199
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/19/2022
Last updated
10/19/2022
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