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Individual

DR. ROGER WILLIAMS EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9300 E 29TH ST N, SUITE 310, WICHITA, KS 67226-2182
(316) 858-9000
(316) 858-9005
Mailing address
9300 E 29TH ST N, SUITE 310, WICHITA, KS 67226-2182
(316) 858-9000
(316) 858-9005

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-13261
KS
207RC0000X
Cardiovascular Disease Physician
Primary
04-13261
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
060036462
RAILROAD MEDICARE
05
100133670F
KS
05
100206090B
OK
Enumeration date
05/02/2006
Last updated
02/10/2015
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