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Individual

DR. OLAN EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1722 PINE ST, SUITE 804, MONTGOMERY, AL 36106-1103
(334) 834-7221
(334) 241-9848
Mailing address
1722 PINE ST, SUITE 804, MONTGOMERY, AL 36106-1103
(334) 834-7221
(334) 241-9848

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
00015591
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00004340709
AETNA
AL
05
000082998
AL
01
040017480
RAILROAD MEDICARE
AL
01
51082998
BCBS
AL
01
630755234
UNITED HEALTHCARE
AL
01
C36744
SENIORS FIRST
AL
01
GEHA
630755234
AL
Enumeration date
08/24/2006
Last updated
07/08/2007
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