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Individual

TYLER LEE EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-3871
Mailing address
705 LAKESIDE LANDING CT, EVANS, GA 30809-6112

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
6396
GA
207L00000X
Anesthesiology Physician
PG158664
OR

Other

Enumeration date
06/20/2012
Last updated
03/20/2016
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