Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 23381 | KY |
Y | 208600000X | Surgeon | 23381 | KY |
N | 2086X0206X | Surgical Oncologist | 23381 | KY |
NPI | 1295834331 |
---|---|
Provider Name | Dr. Bernard Mark Evers |
First Address | Lexington, KY 40536-0093 |
Second Address | Lexington, KY 40536-0093 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/09/2006 |
Last Update Date | 01/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
135551304 | (05) | TX |
E69972 | (02) | TX |