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NPI Code Detail

MEDICARE: DR. WILLIAM HERSHEY EVANS O.D.

MEDICARE:  DR. WILLIAM HERSHEY EVANS  O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometristOPT 6649 TPACA
2152W00000XOptometrist1664WI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
260700OTHERWIDEAN HEALTH INSURANCE
32029369OTHERWIPHYSICIANS PLUS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5SD0066490OTHERCABLUE SHIELD PROVIDER ID#

General Provider Information

NPI Number : 1225034200
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. WILLIAM HERSHEY EVANS O.D.
Provider Business Mailing Address
First Line : 165 W HASELTINE ST
Second Line :
City : RICHLAND CENTER
State : WI
Zip : 53581-2552
Country : US
Telephone Number : 608-647-8995
Fax Number : 608-647-2569
Provider Business Practice Location Address
First Line : 165 W HASELTINE ST
Second Line :
City : RICHLAND CENTER
State : WI
Zip : 53581-2552
Country : US
Telephone Number : 608-647-8995
Fax Number : 608-647-2569
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2005
Last Update Date : 04/29/2014

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Directions to “ DR. WILLIAM HERSHEY EVANS O.D.” Practice Location

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