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Individual

EVIN LAKE GUILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
617 23RD ST STE 106, ASHLAND, KY 41101-2880
(606) 329-1770
(606) 329-1768
Mailing address
PO BOX 746647, ATLANTA, GA 30374-6647
(904) 388-6518
(904) 384-1005

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
OS21210
FL
207T00000X
Neurological Surgery Physician
Primary
TP273
KY

Other

Enumeration date
03/28/2017
Last updated
05/30/2025
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