Individual
DR. ANDREW L. EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1235 E CHEROKEE ST, SPRINGFIELD, MO 65804-2203
(417) 820-2600
(417) 820-2100
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
R8D68
MO
208M00000X
Hospitalist Physician
Primary
R8D68
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116854001
—
AR
05
—
1174688519
—
MO
01
—
431560263
TRICARE
MO
01
—
P00113363
RR MCR
MO
Enumeration date
12/26/2006
Last updated
05/30/2017
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