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NPI Code Detail

MEDICARE: KENNETH D EVANS

MEDICARE:   KENNETH D EVANS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist3295MT
2231H00000XAudiologist3095MT
3237600000XAudiologist-Hearing Aid Fitter3095MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1194168013
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH D EVANS
Provider Business Mailing Address
First Line : 317 S ORANGE ST
Second Line :
City : MISSOULA
State : MT
Zip : 59801-1810
Country : US
Telephone Number : 406-549-1951
Fax Number :
Provider Business Practice Location Address
First Line : 317 S ORANGE ST
Second Line :
City : MISSOULA
State : MT
Zip : 59801-1810
Country : US
Telephone Number : 406-549-1951
Fax Number : 406-542-5682
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2013
Last Update Date : 03/28/2025

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Directions to “ KENNETH D EVANS ” Practice Location

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