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NPI Code Detail

MEDICARE: RAYMOND C EVANS MD

MEDICARE: RAYMOND C EVANS MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician023450GA

General Provider Information

NPI Number : 1093708257
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMOND C EVANS MD
Provider Business Mailing Address
First Line : 901 18TH ST E
Second Line :
City : TIFTON
State : GA
Zip : 31794-3648
Country : US
Telephone Number : 912-287-1515
Fax Number : 912-287-1394
Provider Business Practice Location Address
First Line : 901 18TH ST E
Second Line :
City : TIFTON
State : GA
Zip : 31794-3648
Country : US
Telephone Number : 912-287-1515
Fax Number : 912-287-1394
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2005
Last Update Date : 11/17/2007

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Directions to “ RAYMOND C EVANS MD” Practice Location

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