Evans, Beau Barker

Evans, Beau Barker is an sole proprietor health care provider with primary practice located at 202 S 6Th St , Henryetta OK 74437-5002. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Evans, Beau Barker can be contacted via phone (918) 652-4404.

Contact Information

Primary practice address
202 S 6Th St Henryetta OK 74437-5002
Phone: (918) 652-4404
Fax: (918) 652-4445
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 6188 Oklahoma

Profile Details

NPI number 1699086470
LBN Legal business name Evans, Beau Barker
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 28th, 2010
Last updated Dec 12th, 2016 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699086470 NPPES
Oklahoma MEDICAID 200302490A

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