Organization
EVANS PEDIATRIC CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS EUGENE EVANS D.O. (OWNER)
(816) 351-6385
Entity
Organization
Contact information
Practice address
3912 SHERMAN AVE, SAINT JOSEPH, MO 64506-3648
(816) 233-5959
(816) 233-5960
Mailing address
3912 SHERMAN AVE, SAINT JOSEPH, MO 64506-3648
(816) 233-5959
(816) 233-5960
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
110143
MO
Other
Enumeration date
06/17/2006
Last updated
11/28/2011
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