Individual
EVAN ANDREW LOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EVAN LOS, M.D.
Contact information
Practice address
408 N STATE OF FRANKLIN RD, SUITE 31B, JOHNSON CITY, TN 37604-6089
(423) 431-4946
(423) 431-4947
Mailing address
408 N STATE OF FRANKLIN RD, SUITE 31B, JOHNSON CITY, TN 37604-6089
(423) 431-4946
(423) 431-4947
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
54336
TN
208000000X
Pediatrics Physician
MD163055
OR
2080P0205X
Pediatric Endocrinology Physician
Primary
54336
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174842348
—
VA
05
—
Q022585
—
TN
Enumeration date
05/26/2010
Last updated
03/03/2025
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