Provider Demographics
NPI:1538320320
Name:JANE T. ST CLAIR, MD, PC
Entity Type:Organization
Organization Name:JANE T. ST CLAIR, MD, PC
Other - Org Name:WELLBEINGS OCCUPATIONAL HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:TURLEY
Authorized Official - Last Name:ST CLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MEDICAL DOCTOR
Authorized Official - Phone:404-607-9737
Mailing Address - Street 1:851 SPRINGDALE RD NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-4617
Mailing Address - Country:US
Mailing Address - Phone:404-373-5223
Mailing Address - Fax:
Practice Address - Street 1:3300 HOLCOMB BRIDGE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:NORCROSS
Practice Address - State:GA
Practice Address - Zip Code:30092-5404
Practice Address - Country:US
Practice Address - Phone:770-449-5161
Practice Address - Fax:770-449-3272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA24485261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAE32738Medicare UPIN