Individual
DR. BRIAN EVELAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3251 BAGNELL DAM BLVD, LAKE OZARK, MO 65049-9745
(573) 365-3717
Mailing address
1356 ARBOR CT, OSAGE BEACH, MO 65065-2461
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T03452
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170546
BLUECROSS BLUESHIELD
MO
01
—
535606
HEALTHLINK
MO
Enumeration date
08/02/2006
Last updated
07/08/2007
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