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General NPI Number Information
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NPI Number | 1689851941
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Entity Type | Organization
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Legal Business Name | ERIC A EVANS MD PC
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Dates
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Enumeration Date | 01/29/2008
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 640 E 700 S STE 10B
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City | SAINT GEORGE
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State | UT
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Zip | 84770-4036
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Country | US
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Telephone | 435-652-9127
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Fax | 435-674-7339
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Provider Business Mailing Address
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Address Line | PO BOX 911928
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City | ST GEORGE
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State | UT
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Zip | 84791-1928
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Country | US
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Telephone | 435-652-9127
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Fax | 435-674-7339
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Authorized Official
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Title or Position | PRESIDENT
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Name | ERIC A EVANS
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Credential | MD
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Telephone | 435-652-9127
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 3561261205
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License Number State | UT
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