Provider Demographics
NPI:1619935020
Name:MCEVER, VIRGLE W III (MD)
Entity Type:Individual
Prefix:
First Name:VIRGLE
Middle Name:W
Last Name:MCEVER
Suffix:III
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 1:1701 WATSON BLVD.
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31093
Mailing Address - Country:US
Mailing Address - Phone:478-923-0144
Mailing Address - Fax:478-923-3471
Practice Address - Street 1:1701 WATSON BLVD
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31093-3633
Practice Address - Country:US
Practice Address - Phone:478-923-0144
Practice Address - Fax:478-923-3471
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA236589208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00333704AMedicaid
GA020010079OtherRAILROAD MEDICARE
GA00333704AMedicaid