Individual
ERIC R EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4189 WESTLAWN S, IOWA CITY, IA 52242-1100
(319) 353-5959
(319) 335-7247
Mailing address
4189 WESTLAWN S, IOWA CITY, IA 52242-1100
(319) 353-5959
(319) 335-7247
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26811
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2042697
—
IA
01
—
45368
WELLMARK BCBS
IA
01
—
46837
MEDICARE PROVIDER NUMBER
—
Enumeration date
09/27/2005
Last updated
09/28/2007
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