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Organization

PERRY W EVANS JR DO PC

Active
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Organization

PERRY W EVANS JR DO PC

Active
Parent organization
PERRY W EVANS JR DO PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
PERRY W EVANS JR DO PC
Authorized official
DR. PERRY WILLIAM EVANS JR. DO (OWNER)
(918) 358-2592
Entity
Organization

Contact information

Practice address
119 S BROADWAY ST, CLEVELAND, OK 74020-4614
(918) 358-2592
(918) 358-3133
Mailing address
119 S BROADWAY ST, CLEVELAND, OK 74020-4614
(918) 358-2592
(918) 358-3133

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—

Other

Enumeration date
07/15/2010
Last updated
07/15/2010
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