Healthcare Provider Details

I. General information

NPI: 1043121718
Provider Name (Legal Business Name): EVAN MK GARRETT FAMILY MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CORPORATE PL
MIDDLETOWN RI
02842-6406
US

IV. Provider business mailing address

1 CORPORATE PL
MIDDLETOWN RI
02842-6406
US

V. Phone/Fax

Practice location:
  • Phone: 401-619-4884
  • Fax: 401-619-4886
Mailing address:
  • Phone: 401-619-4884
  • Fax: 401-619-4886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: EVAN MK GARRETT
Title or Position: PHYSICIAN OWNER
Credential: DO
Phone: 580-579-0292