Provider Demographics
NPI:1568781409
Name:EVANS, CHLOE DIANE (DO)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:DIANE
Last Name:EVANS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CHLOE
Other - Middle Name:DIANE
Other - Last Name:ARMSTEAD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:4905 COURTNEY DR
Mailing Address - Street 2:
Mailing Address - City:FOREST PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30297-1427
Mailing Address - Country:US
Mailing Address - Phone:404-366-3636
Mailing Address - Fax:404-362-0808
Practice Address - Street 1:428 WINN CT
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1726
Practice Address - Country:US
Practice Address - Phone:404-366-3636
Practice Address - Fax:404-362-0808
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA70699208000000X
TXBP1 - 0037981208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics