Individual
DR. ELESYIA D. OUTLAW-EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(770) 400-6349
(770) 400-6349
Mailing address
600 CELEBRATE LIFE PKWY, NEWNAN, GA 30265-8001
(770) 343-7735
(770) 400-6925
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
2004
MO
2085R0001X
Radiation Oncology Physician
205177
LA
2085R0001X
Radiation Oncology Physician
Primary
35435
AL
Other
Enumeration date
03/22/2007
Last updated
02/01/2023
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