Organization
ELLIS W EVANS SR MD FACS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLIS W EVANS SR. MD (OWNER)
(478) 475-1299
Entity
Organization
Contact information
Practice address
770 PINE ST, STE 220, MACON, GA 31201-2173
(478) 475-1299
(478) 475-0799
Mailing address
PO BOX 26040, MACON, GA 31221-6040
(478) 475-1299
(478) 475-0799
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
013745
GA
Other
Enumeration date
07/11/2008
Last updated
07/11/2008
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