Organization
DESOTO HEART CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD M EVANS MD (OWNER/PRESIDENT)
(662) 536-3610
Entity
Organization
Contact information
Practice address
391 SOUTHCREST CIR, SUITE 209, SOUTHAVEN, MS 38671-6730
(662) 536-3610
Mailing address
391 SOUTHCREST CIR, SUITE 209, SOUTHAVEN, MS 38671-6730
(662) 536-3610
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
16862
MS
Other
Enumeration date
04/02/2012
Last updated
05/01/2012
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