Individual
JOHN MICHAEL EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1453 E BERT KOUN LOOP, SHREVEPORT, LA 71105-6800
(318) 681-1968
(318) 465-0077
Mailing address
2900 SAINT MICHAEL DR, STE 401, TEXARKANA, TX 75503-5211
(903) 614-7693
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
312414
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2011
Last updated
11/13/2019
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