Individual
BRADLEY EVANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
383 S 300 E, ST GEORGE, UT 84770-3620
(435) 628-2826
Mailing address
383 S 300 E, ST GEORGE, UT 84770-3620
(354) 628-2826
(435) 628-2839
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
12603519-1205
UT
207N00000X
Dermatology Physician
S1396
TX
207ND0101X
MOHS-Micrographic Surgery Physician
12603519-1205
UT
Other
Enumeration date
03/31/2015
Last updated
09/27/2022
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