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General NPI Number Information
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NPI Number | 1699091025
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Entity Type | Organization
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Legal Business Name | JEFFREY K EVANS MD
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Dates
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Enumeration Date | 04/09/2010
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Last Update Date | 08/20/2010
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Provider Practice Location Address
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Address Line | 5 WINDHAVEN DR
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City | FORT SMITH
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State | AR
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Zip | 72903-2610
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Country | US
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Telephone | 479-462-7803
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Fax | 888-577-9955
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Provider Business Mailing Address
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Address Line | PO BOX 11684
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City | FORT SMITH
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State | AR
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Zip | 72917-1684
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Country | US
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Telephone | 479-462-7803
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Fax | 888-577-9955
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Authorized Official
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Title or Position | MD
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Name | DR. JEFFERY K EVANS
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Credential | MD
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Telephone | 479-522-0832
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | C-7265
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License Number State |
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