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General NPI Number Information
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NPI Number | 1619913761
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Entity Type | Individual
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Provider Name | WILLIAM J EVANS MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 05/02/2022
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Provider Practice Location Address
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Address Line | 3631 BIENVILLE BLVD SUITE A
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-5702
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Country | US
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Telephone | 228-818-9620
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Fax | 228-818-9750
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Provider Business Mailing Address
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Address Line | 3631 BIENVILLE BLVD SUITE A
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-5702
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Country | US
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Telephone | 228-818-9620
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Fax | 228-818-9750
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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 | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 18874
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 18874
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License Number State | MS
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