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Individual

DR. JOHN SANFORD EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1050 MCDONOUGH RD, JACKSON, GA 30233-1524
(770) 775-7861
Mailing address
14050 NW 14TH ST, SUITE 190, SUNRISE, FL 33323-2865
(800) 424-3672
(954) 377-3042

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
016508
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
GA
Enumeration date
06/08/2006
Last updated
05/20/2011
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