Dr. Larry D Evans
Oral and Maxillofacial Pathology
3550 S 4th St Suite 240
Leavenworth
, Kansas 66048-5071
Dr. Larry D Evans
Oral and Maxillofacial Pathology
3550 S 4th St Suite 240
Leavenworth
, Kansas 66048-5071
(913) 772-0851
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Dr. Larry D Evans
- 3550 S 4th St Suite 240
- Leavenworth, KS
- Zip : 66048-5071
- Fax : (913) 772-0851
- Phone : (913) 772-4334
Second Address
- Dr. Larry D Evans
- 3550 S 4th St Suite 240
- Leavenworth, KS
- Zip : 66048-5071
- Fax : (913) 772-0851
- Phone : (913) 772-4334
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 4672 | KS |
National Provider Identifier
| NPI | 1356316202 |
|---|---|
| Provider Name | Dr. Larry D Evans |
| First Address | Leavenworth, KS 66048-5071 |
| Second Address | Leavenworth, KS 66048-5071 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 22/02/2006 |
| Last Update Date | 09/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T73575 | (02) | KS |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.