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General NPI Number Information
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NPI Number | 1346717212
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Entity Type | Individual
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Provider Name | BENNETT LAMONDE EVANS DPM
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Gender | Male
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Dates
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Enumeration Date | 10/30/2018
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 1645 OWEN DR
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City | FAYETTEVILLE
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State | NC
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Zip | 28304-3425
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Country | US
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Telephone | 910-615-3668
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Fax |
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Provider Business Mailing Address
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Address Line | 1061 HARMON AVE
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City | FORT STEWART
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State | GA
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Zip | 31314-5641
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Country | US
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Telephone | 912-435-6965
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Fax |
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 817
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 817
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | POD001507
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License Number State | GA
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Taxonomy #4
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 817
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License Number State | NC
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