Healthcare Provider Details

I. General information

NPI: 1619910338
Provider Name (Legal Business Name): WILLIAM CARLTON EVERTS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 G ST
SPRINGFIELD OR
97477-4113
US

IV. Provider business mailing address

1435 G ST
SPRINGFIELD OR
97477-4113
US

V. Phone/Fax

Practice location:
  • Phone: 541-735-9420
  • Fax: 541-747-9870
Mailing address:
  • Phone: 541-735-9420
  • Fax: 541-747-9870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO176944
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: