Evans Mill Family Practice

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

63421 Issued in GA

Legal business name

EVANS MILL FAMILY PRACTICE

Practice address

2724 Evans Mill Rd
Lithonia, GA 30058-7417

Phone

(770) 484-7172

NPI assigned

Jan 21, 2010

Last updated

Jan 21, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Purushottam Kumar Garg, M.D.

Title

Owner

Phone

(850) 995-8811

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1264032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264032000000",
    "number": "1316278948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2724 EVANS MILL RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587417",
            "telephone_number": "770-484-7172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2724 EVANS MILL RD",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300587417",
            "telephone_number": "770-484-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVANS MILL FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-21",
        "last_updated": "2010-01-21",
        "status": "A",
        "authorized_official_last_name": "GARG",
        "authorized_official_first_name": "PURUSHOTTAM",
        "authorized_official_middle_name": "KUMAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-995-8811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "GA",
            "license": "63421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Fagan Transportation LLC

• Health Service Clinic/Center in Lithonia, GA
• Providers in Lithonia, GA by specialty
• Health Service Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.