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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1235179078 NPPES
Georgia MEDICAID 003124605B
Georgia Other PSY003597

Popular Providers