Evans, Lance
Evans, Lance is an individual health care provider with primary practice located at 1120 15Th Street Department Of Anesthesiology, Augusta GA 30912. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Evans, Lance can be contacted via phone (706) 721-3871.Contact Information
Primary practice address
1120 15Th Street Department Of Anesthesiology
Augusta GA 30912
Phone: (706) 721-3871
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY003597 | Georgia |
Profile Details
| NPI number | 1235179078 |
|---|---|
| LBN Legal business name | Evans, Lance |
| Credentials | PHD. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 8th, 2006 |
| Last updated | Oct 28th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235179078 | NPPES |
| Georgia | MEDICAID | 003124605B | |
| Georgia | Other | PSY003597 |
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