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Individual

DR. JUSTIN P EVANS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
250 HOSPITAL PL, SOLDOTNA, AK 99669-6999
(907) 714-4404
Mailing address
3300 PROVIDENCE DR, SUITE 207, ANCHORAGE, AK 99508-4671
(907) 561-0005
(907) 563-9140

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
46976
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
872956500
MN
Enumeration date
01/12/2006
Last updated
07/20/2020
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