Individual
EVAN KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1514 JEFFERSON HWY, JEFFERSON, LA 70121-2429
(866) 624-7637
Mailing address
2421 DAUPHINE ST UNIT B, NEW ORLEANS, LA 70117-7801
(443) 841-5996
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
325163
LA
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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