MEDICARE: DR. FRANK J EVANS DDS

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
1	122300000X	Dentist	4359	OK

General Provider Information

NPI Number	:	1942352919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK J EVANS DDS

Provider Business Mailing Address
First Line	:	PO BOX 206
Second Line	:
City	:	FORT GIBSON
State	:	OK
Zip	:	74434-0206
Country	:	US
Telephone Number	:	918-478-2341
Fax Number	:	918-478-2341

Provider Business Practice Location Address
First Line	:	802 S LEE
Second Line	:
City	:	FORT GIBSON
State	:	OK
Zip	:	74434-0206
Country	:	US
Telephone Number	:	918-478-2341
Fax Number	:	918-478-2341

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2007
Last Update Date	:	07/08/2007

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Directions to “ DR. FRANK J EVANS DDS” Practice Location

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