Individual
DR. CURTIS C. EVENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1229 E SEMINOLE ST, SPRINGFIELD, MO 65804-2227
(417) 820-2064
(417) 820-8716
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
100452
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122273001
—
AR
05
—
203345509
—
MO
01
—
81219
AR BLUE SHIELD #
MO
Enumeration date
02/14/2007
Last updated
10/02/2014
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