Provider Demographics
NPI:1710678925
Name:SMG-OCCUPATIONAL HEALTH CLINIC
Entity Type:Organization
Organization Name:SMG-OCCUPATIONAL HEALTH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CMA
Authorized Official - Prefix:
Authorized Official - First Name:KATELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SATTERFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-739-3354
Mailing Address - Street 1:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:CLAXTON
Mailing Address - State:GA
Mailing Address - Zip Code:30417-0217
Mailing Address - Country:US
Mailing Address - Phone:912-739-3354
Mailing Address - Fax:912-739-3374
Practice Address - Street 1:342 E BRAZELL ST
Practice Address - Street 2:
Practice Address - City:REIDSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30453-5046
Practice Address - Country:US
Practice Address - Phone:912-557-1950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOUTHERN MEDICAL GROUP, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-05-18
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care