Individual
JOHN K EVETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
(540) 985-6930
Mailing address
PO BOX 2080, KILMARNOCK, VA 22482-2080
(804) 435-3508
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101047166
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010046246
—
VA
05
—
010046271
—
VA
05
—
010420903
—
VA
01
—
184296
BLUE SHIELD
VA
Enumeration date
04/10/2006
Last updated
05/02/2008
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