Organization
ST. MARY'S MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
D. MONTEZ CARTER (PRESIDENT & CEO)
(706) 389-3930
Entity
Organization
Contact information
Practice address
355 CLEAR CREEK PKWY, SUITE 1008, LAVONIA, GA 30553-4174
(706) 356-6894
(706) 356-4132
Mailing address
PO BOX 48089, ATHENS, GA 30604-8089
(706) 389-3930
(706) 389-3951
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
09/14/2016
Last updated
04/02/2018
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