Individual
DR. PERRY WILLIAM EVANS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
119 S BROADWAY ST, CLEVELAND, OK 74020-4614
(918) 358-2592
(918) 358-3133
Mailing address
119 S BROADWAY ST, CLEVELAND, OK 74020-4614
(918) 358-2592
(918) 358-3133
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1856
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100116960A
—
OK
Enumeration date
11/09/2005
Last updated
03/09/2010
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