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Individual

PHOEBE L EVERSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
75 BEEKMAN ST, PLATTSBURGH, NY 12901-1438
(518) 561-2000
(518) 561-0881
Mailing address
PO BOX 2868, PLATTSBURGH, NY 12901-0259
(518) 562-7900
(518) 562-7933

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
157114
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000490094001
BSNENY
NY
05
01936589
NY
01
114406
VALUE OPTIONS
NY
01
90031
MVP
NY
01
PE01760N10
EMPIRE BC BS
NY
Enumeration date
01/02/2007
Last updated
08/17/2007
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