Provider Demographics
NPI:1609921402
Name:FAMILY PHYSICIANS OF EVANS
Entity Type:Organization
Organization Name:FAMILY PHYSICIANS OF EVANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:PARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:706-854-2170
Mailing Address - Street 1:465 N BELAIR RD
Mailing Address - Street 2:SUITE 1C
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-3188
Mailing Address - Country:US
Mailing Address - Phone:706-854-2160
Mailing Address - Fax:706-854-2930
Practice Address - Street 1:465 N BELAIR RD
Practice Address - Street 2:SUITE 1C
Practice Address - City:EVANS
Practice Address - State:GA
Practice Address - Zip Code:30809-3188
Practice Address - Country:US
Practice Address - Phone:706-854-2160
Practice Address - Fax:706-854-2930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP3966Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER