Doctor Name: | MRS. GAIL A. EVANS |
NPI Number: | 1093714586 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHYSICIAN ASSISTANT |
License Number: | 1036982 |
Business Practice Address: | 210 Dillon Circle Dcg-imt Coe Fort Eustis, VA - 23604 |
Business Phone Number: | 9124297762 |
Business Fax Number: | |
Mailing Address: | 210 Dillon Circle, Dcg-imt Coe FORT EUSTIS |
State: | VA |
Postal Code: | 23604 |
Phone Number: | 9124297762 |
Fax Number: | |
NPI Enumeration Date: | 07/18/2005 |
NPI Last Update Date: | 05/20/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 1036982 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |