Provider Demographics
NPI:1336870989
Name:GEORGE, EVALYN IONE (MD)
Entity Type:Individual
Prefix:DR
First Name:EVALYN
Middle Name:IONE
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 MADDOX DR
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30909-9518
Mailing Address - Country:US
Mailing Address - Phone:360-621-3779
Mailing Address - Fax:
Practice Address - Street 1:300 E HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30905-9518
Practice Address - Country:US
Practice Address - Phone:360-621-3779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-23
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program