Provider Demographics
NPI:1336140300
Name:EVINS, STARLING C (MD)
Entity Type:Individual
Prefix:
First Name:STARLING
Middle Name:C
Last Name:EVINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P O BOX 409879
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-9879
Mailing Address - Country:US
Mailing Address - Phone:615-261-6000
Mailing Address - Fax:615-261-6052
Practice Address - Street 1:4601 CAROTHERS PKWY
Practice Address - Street 2:SUITE 475
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067
Practice Address - Country:US
Practice Address - Phone:615-790-1660
Practice Address - Fax:615-790-3705
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-02
Last Update Date:2012-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD10984208800000X
TN10984208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3165472Medicare ID - Type Unspecified
TN340011682Medicare PIN
B03112Medicare UPIN
TNB03112Medicare UPIN