Individual
EVAN XANTHOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1600 DELTA WATERS RD STE 107, MEDFORD, OR 97504-9114
(541) 858-2514
Mailing address
83 N CHESTERVILLE RD, FARMINGTON, ME 04938-6221
(207) 491-9812
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA189549
OR
Other
Enumeration date
07/24/2018
Last updated
07/24/2018
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