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Individual

EVAN R WADSWORTH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
510 RIDGE RD, WASHINGTON, IN 47501-8908
(812) 698-7760
Mailing address
510 RIDGE RD, WASHINGTON, IN 47501-8908
(812) 698-7760

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002428A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300012898
IN
Enumeration date
02/13/2018
Last updated
05/20/2026
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