DR. GLENN HAMILTON EVANS SR. (NPI# 1285623744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285623744 |
| Entity Type | Individual |
| Full Name | DR. GLENN HAMILTON EVANS SR. |
| Credential | MD |
| Practice Address |
1305 Ocilla Rd Douglas GA 31533-2209 |
| Mailing Address |
Po Box 14804 Belfast ME 04915-4043 |
| Practice Telephone | 9123840600 |
| Practice Fax Number | 9123840601 |
| Mailing Telephone | 9123841477 |
| Mailing Fax Number | 9123841470 |
| Enumeration Date | 2005-10-18 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
034826 | GA | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
034826 | GA | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 W Northside Dr Bldg G, Valdosta, GA 316021754 | 9123840600 | 9123840601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538142492 | Glenn Jeffrey Evans | Dentist | 703 Parkway Dr, Wheaton, IL 60187-3646 | 2005-11-23 |
| 1235511882 | Glenn Evans | Dentist | 1151 E Main St, Suite A, Radford, VA 24141-1761 | 2015-06-19 |
| 1396808739 | Glenn William Evans | Counselor | 2091 Professional Dr, Suite I-1, Flint, MI 48532-3657 | 2006-12-18 |
| Street Address |
1305 OCILLA RD |
| City | DOUGLAS |
| State | GA |
| Zip Code | 31533-2209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619521820 | Marci Mcquaig Johnson | Nurse Practitioner | 1305 Ocilla Rd, Douglas, GA 31533-2209 | 2019-07-25 |
| 1003315243 | Crh Physician Practices, LLC | Clinic/Center | 1305 Ocilla Rd, Douglas, GA 31533 | 2018-02-02 |
| 1447422787 | Debbie L. Dismuke D.m.d.,p.c. | Dentist | 1305 Ocilla Rd, Douglas, GA 31533-2209 | 2008-03-27 |
| 1336254275 | Debbie L Dismuke | Dentist | 1305 Ocilla Rd, Douglas, GA 31533-2209 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508470964 | Swain Drug Company LLC | Pharmacy | 855 Bowens Mill Rd Sw Suite E, Douglas, GA 31533 | 2020-09-03 |
| 1811528649 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 211 North Street, Douglas, GA 31533 | 2020-01-30 |
| 1952940793 | Teresa Smith | Pharmacist | 901 W Ward St, Douglas, GA 31533 | 2019-12-26 |
| 1447641048 | Jennifer Spivey | Nurse Practitioner | 326 Shirley Avenue, Douglas, GA 31533 | 2015-02-18 |
| 1972914497 | Jessica Lynne Courson | Nurse Practitioner | 903 West Ward Street, Suite B, Douglas, GA 31533 | 2014-05-19 |
| 1063840296 | South Central Primary Care Center | Clinic/Center | 303 Shirley Ave, Ste B, Douglas, GA 31533 | 2013-10-25 |
| 1336411008 | Unison Behavioral Health | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 118 Coweta Avenue South, Douglas, GA 31533 | 2012-01-27 |
| 1346482700 | V and V Clinic | Pediatrics | 1020 West Bryan Street, Douglas, GA 31533 | 2009-04-01 |
| 1063650406 | Jayla Snipes Bullock | Speech-Language Pathologist | 618 Bowens Mill Road Sw, Douglas, GA 31533 | 2009-01-22 |
| 1417112707 | Southern Community Services Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 315 S. Gaskin Ave, Douglas, GA 31533 | 2008-07-25 |
| Find all providers in zip 31533 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669019394 | Champ Vascular, LLC | Internal Medicine | 1825 Highway 34 E Ste 3400, Newnan, GA 30265-6423 | 2019-12-02 |
| 1174006159 | Kendall M Griffith Md LLC | Internal Medicine | 1497 Fair Rd Ste 311, Statesboro, GA 30458-0828 | 2018-09-14 |
| 1558869826 | Coordinated Health of Ga, LLC | Internal Medicine | 10 Glenlake Pkwy Ste 130c, Atlanta, GA 30328-3495 | 2018-01-31 |
| 1447559604 | David Brendan Casey | Internal Medicine | 1700 Tree Ln Ste 100, Snellville, GA 30078-6749 | 2011-03-26 |
| 1730404120 | Deepali Nivas Tukaye | Internal Medicine | 1505 Northside Blvd Ste 3400, Cumming, GA 30041-8223 | 2010-03-29 |
| 1659560647 | Oduwole Organization Inc | Internal Medicine | 1415 Highway 85 N Ste 310-296, Fayetteville, GA 30214-7738 | 2007-10-16 |
| 1053487462 | Tiftarea Cardiology | Internal Medicine | 907 E. 18th St, Ste 100, Tifton, GA 31794 | 2006-11-28 |
| 1255412094 | Jeetendra B Patel | Internal Medicine | 1301 Sigman Rd Ne Ste 200, Conyers, GA 30012 | 2006-10-18 |
| 1811082605 | Cardiac Disease Specialists, PC | Internal Medicine | 296 Merchants Sq, Dallas, GA 30132-5029 | 2006-10-04 |
| 1770508756 | Hunt Dandridge Anderson | Internal Medicine | 4500 Hospital Blvd, Suite 230, Roswell, GA 30076-0003 | 2006-07-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.