Healthcare Provider Details

I. General information

NPI: 1609921402
Provider Name (Legal Business Name): FAMILY PHYSICIANS OF EVANS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

465 N BELAIR RD SUITE 1C
EVANS GA
30809-3188
US

IV. Provider business mailing address

465 N BELAIR RD SUITE 1C
EVANS GA
30809-3188
US

V. Phone/Fax

Practice location:
  • Phone: 706-854-2160
  • Fax: 706-854-2930
Mailing address:
  • Phone: 706-854-2160
  • Fax: 706-854-2930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. BEVERLY LYNN PARNELL
Title or Position: PRACTICE MANAGER
Credential: CMA
Phone: 706-854-2170