Individual
MRS. LAURA JANE EVORS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
775 POPLAR RD STE 120, NEWNAN, GA 30265-8301
(770) 400-4510
(678) 423-2737
Mailing address
775 POPLAR RD STE 120, NEWNAN, GA 30265-8301
(770) 400-4510
(678) 423-2737
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
39393
SC
207V00000X
Obstetrics & Gynecology Physician
Primary
82210
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
393933
—
SC
01
—
SC89176162
MEDICARE PIN
SC
Enumeration date
12/09/2008
Last updated
04/22/2019
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