Individual
SCOTT BRUCE EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1309 BLUE LAKES BLVD N, TWIN FALLS, ID 83301-3310
(208) 933-4442
Mailing address
PO BOX 27128, SALT LAKE CITY, UT 84127-0128
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7681201
ID
363A00000X
Physician Assistant
Primary
9171010-1206
UT
363AS0400X
Surgical Physician Assistant
9171010-1206
UT
Other
Enumeration date
08/12/2024
Last updated
06/11/2026
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