Individual
EVAN SANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 W 4TH ST STE 200, COOKEVILLE, TN 38501-2452
(931) 528-1575
Mailing address
100 W 4TH ST STE 200, COOKEVILLE, TN 38501-2452
(931) 528-1575
(931) 526-2962
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
60732
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q058525
—
TN
Enumeration date
04/10/2015
Last updated
09/22/2020
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