Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 067560 | GA |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 30619 | AL |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 5583 | AL |
Y | 204E00000X | Oral & Maxillofacial Surgeon | 30619 | AL |
N | 204E00000X | Oral & Maxillofacial Surgeon | 67562 | GA |
NPI | 1427266345 |
---|---|
Provider Name | Dr. Joshua Edward Everts |
First Address | Alabaster, AL 35007-8707 |
Second Address | Alabaster, AL 35007-8707 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 25/07/2015 |