| Organization Name: | ST. MARY'S MEDICAL GROUP, INC |
| NPI Number: | 1003264524 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARTY HUTSON (DIRECTOR) |
| Mailing Address: | 1622 Mars Hill Rd Ste C Watkinsville |
| State: | GA US |
| Postal Code: | 306774893 |
| Phone Number: | 7063893880 |
| Fax Number: | |
| NPI Enumeration Date: | 05/25/2016 |
| NPI Last Update Date: | 06/03/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RR0500X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Rheumatology |
| Taxonomy Definition: | An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |