Evans, Sr
Evans, Sr is an sole proprietor health care provider with primary practice located at 1604 Leflore Ave , Greenwood MS 38930. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecology, which is considered as his primary health care specialty. Evans, Sr can be contacted via phone (662) 453-0532.Contact Information
Primary practice address
1604 Leflore Ave
Greenwood MS 38930
Phone: (662) 453-0532
Fax: (662) 453-3079
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecology | 207VG0400X | 04978 | Mississippi |
Profile Details
| NPI number | 1598847253 |
|---|---|
| LBN Legal business name | Evans, Sr |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Apr 30th, 2008 - about 17 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 | 1598847253 | NPPES |
| Mississippi | MEDICAID | 00125971 | |
| Mississippi | Other | 020052768 |
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