Provider Demographics
NPI:1548529290
Name:CAUSEY, STEPHANIE GREATHOUSE (PA)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:GREATHOUSE
Last Name:CAUSEY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:GREATHOUSE
Other - Last Name:CAVINESS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:100 MIMOSA DRIVE 2ND FLOOR
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792
Mailing Address - Country:US
Mailing Address - Phone:229-551-0083
Mailing Address - Fax:229-227-9642
Practice Address - Street 1:900 CAIRO RD
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-4255
Practice Address - Country:US
Practice Address - Phone:229-227-5102
Practice Address - Fax:229-227-5187
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA006430363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant