Individual
LAWRENCE GLENNON EVANS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3824 WATSON RD, SAINT LOUIS, MO 63109-1237
(314) 352-4400
(314) 352-8496
Mailing address
3824 WATSON RD, SAINT LOUIS, MO 63109-1237
(314) 352-4400
(314) 352-8496
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
31680
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009102
EXCLUSIVE CHOICE
MO
01
—
0900150
UNITED HEALTHCARE
MO
01
—
100636
HEALTHLINK
MO
01
—
200015590
MEDICARE RAILROAD
MO
01
—
21931
BLUE CROSS/BLUE SHIELD
MO
01
—
49982
GROUP HEALTH PLAN GHP
MO
Enumeration date
06/21/2005
Last updated
07/08/2007
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