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General NPI Number Information
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NPI Number | 1225034200
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Entity Type | Individual
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Provider Name | WILLIAM HERSHEY EVANS O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 165 W HASELTINE ST
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-2552
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Country | US
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Telephone | 608-647-8995
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Fax | 608-647-2569
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Provider Business Mailing Address
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Address Line | 165 W HASELTINE ST
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City | RICHLAND CENTER
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State | WI
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Zip | 53581-2552
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Country | US
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Telephone | 608-647-8995
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Fax | 608-647-2569
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT 6649 TPA
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1664
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License Number State | WI
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