Individual
DR. JOSEPH CEDRIC EVANS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19101 E VALLEY VIEW PKWY, SUITE B, INDEPENDENCE, MO 64055-6904
(816) 254-9292
(816) 795-8996
Mailing address
19101 E VALLEY VIEW PKWY, SUITE B, INDEPENDENCE, MO 64055-6904
(816) 254-9292
(816) 795-8996
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD32823
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04537013
BLUE CROSS-BLUE SHIELD
MO
05
—
200010403
—
MO
Enumeration date
12/22/2005
Last updated
05/02/2011
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