Individual
JOHN EDWARD EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
901 WALLACE AVE, LEITCHFIELD, KY 42754-1417
(270) 259-5641
(270) 259-5309
Mailing address
901 WALLACE AVE, LEITCHFIELD, KY 42754-1417
(270) 259-5641
(270) 259-5309
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
38545
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64082829
—
KY
Enumeration date
05/27/2006
Last updated
01/30/2019
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