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Individual

DR. BRUCE G EVANS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1160 EAST 3900 SOUTH, SUITE 5000, SALT LAKE CITY, UT 84124-1275
(801) 262-8486
(801) 284-8699
Mailing address
1160 EAST 3900 SOUTH, SUITE 5000, SALT LAKE CITY, UT 84124-1275
(801) 262-8486
(801) 284-8699

Taxonomy

Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
1684391205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
870682101009
UT
05
D0774
UT
Enumeration date
08/19/2005
Last updated
05/18/2011
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