Jerry Evans
Emergency Medical Services
1700 Clinton St
Muskegon
, Michigan 49443
Jerry Evans
Emergency Medical Services
1700 Clinton St
Muskegon
, Michigan 49443
(616) 975-1870
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About
Features
Specialties
- Emergency Medical Services
Languages spoken
- English
Location
First Address
- Jerry Evans
- Po Box 1487
- Muskegon, MI
- Zip : 49443-1487
- Fax : (616) 975-1870
- Phone : (616) 975-1845
Second Address
- Jerry Evans
- 1700 Clinton St
- Muskegon, MI
- Zip : 49443
- Phone : (231) 728-4601
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207PE0004X | Emergency Medical Services | 4301057209 | MI |
National Provider Identifier
| NPI | 1194827808 |
|---|---|
| Provider Name | Jerry Evans |
| First Address | Muskegon, MI 49443-1487 |
| Second Address | Muskegon, MI 49443 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/09/2006 |
| Last Update Date | 17/08/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 930035897 | RAILROAD MEDICARE (01) | MI |
| F49596 | (02) | MI |
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.