Individual
RANDOLPH R EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1670 W MAIN ST, STE100, LEBANON, TN 37087-1344
(615) 453-5155
(615) 444-5915
Mailing address
1670 W MAIN ST, STE100, LEBANON, TN 37087-1344
(615) 453-5155
(615) 444-5915
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
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