Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 12109 | MS |
NPI | 1053414326 |
---|---|
Provider Name | Dr. Jeffrey Neal Evans |
First Address | Atlanta, GA 30384-5827 |
Second Address | Oxford, MS 38655-0768 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/09/2006 |
Last Update Date | 19/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F48440 | (02) | MS |