Individual
BILL P EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3637 4TH ST N, STE 400, ST PETERSBURG, FL 33704-1355
(727) 823-2188
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OS5752
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050023153
RR MEDICARE
FL
05
—
057120200
—
FL
01
—
80504
BCBS
FL
Enumeration date
08/24/2006
Last updated
08/04/2016
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