# PERRY W EVANS JR DO PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PERRY W EVANS JR DO PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1124331475
- **Legal business name:** PERRY W EVANS JR DO PC
- **Authorized official:** DR. PERRY WILLIAM EVANS JR. DO (OWNER)
- **Authorized official phone:** (918) 358-2592

## Contact information

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

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/15/2010
- **Last updated:** 07/15/2010