Provider Demographics
NPI:1821776097
Name:SABLON MEDICAL GROUP LLC
Entity Type:Organization
Organization Name:SABLON MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SABLON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-492-7342
Mailing Address - Street 1:6234 LULLWATER DR
Mailing Address - Street 2:
Mailing Address - City:DOUGLASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30135-3722
Mailing Address - Country:US
Mailing Address - Phone:678-492-7342
Mailing Address - Fax:
Practice Address - Street 1:6234 LULLWATER DRIVE
Practice Address - Street 2:
Practice Address - City:DOUGLASVILLE
Practice Address - State:GA
Practice Address - Zip Code:30135-2412
Practice Address - Country:US
Practice Address - Phone:678-492-7342
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty