Provider Demographics
NPI:1255312815
Name:DONALD C. EVANS, M.D., P.C.
Entity Type:Organization
Organization Name:DONALD C. EVANS, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:M.D./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:C
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-547-4157
Mailing Address - Street 1:572 W MAIN ST
Mailing Address - Street 2:P.O. BOX 2407
Mailing Address - City:CARTERSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30120-3469
Mailing Address - Country:US
Mailing Address - Phone:770-547-4157
Mailing Address - Fax:770-386-4185
Practice Address - Street 1:572 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CARTERSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30120-3469
Practice Address - Country:US
Practice Address - Phone:770-547-4157
Practice Address - Fax:770-386-4185
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-10
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA009810207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty