Healthcare Provider Details

I. General information

NPI: 1336073899
Provider Name (Legal Business Name): EVAN LOMAX
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

684 N MOUNT JULIET RD
MOUNT JULIET TN
37122-3323
US

IV. Provider business mailing address

6044 BAYONET LN
KNOXVILLE TN
37920-5512
US

V. Phone/Fax

Practice location:
  • Phone: 615-758-6800
  • Fax:
Mailing address:
  • Phone: 615-758-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number13196
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: