Individual
RANDOLPH R EVANS
Active
Individual
RANDOLPH R EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
18805
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000089791
BCBS ADVANTAGE
TN
01
—
1238610001
DMERC
TN
01
—
180006421
PALMETTO GBA
TN
01
—
186641053
VISION SERVICE PLAN
TN
01
—
3032849
HEALTHSPRING
TN
05
—
3389788
—
TN
01
—
4065401
AETNA PPO
TN
01
—
621298175
DEFAULT
TN
Enumeration date
07/08/2005
Last updated
08/17/2012
Update your record
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