Individual
DR. LARRY CRAIG EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2770 CORTEZ AVE, IDAHO FALLS, ID 83404-7590
(208) 522-4000
(208) 528-4254
Mailing address
2770 CORTEZ AVE, IDAHO FALLS, ID 83404-7590
(208) 522-4000
(208) 528-4254
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
O-0468
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808040300
—
ID
Enumeration date
11/30/2006
Last updated
08/14/2013
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