Individual
JASON EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
311 JONES MILL RD, STATESBORO, GA 30458-4765
(800) 242-9455
Mailing address
311 JONES MILL RD, STATESBORO, GA 30458-4765
(800) 242-9455
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
007834
GA
Other
Enumeration date
12/09/2015
Last updated
12/09/2015
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