Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 007090 | AZ |
NPI | 1003252123 |
---|---|
Provider Name | Kevin Evans |
First Address | Tucson, AZ 85712-6300 |
Second Address | Tucson, AZ 85712-6300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2013 |
Last Update Date | 17/03/2018 |