Evans, Clifford J

Evans, Clifford J is an individual health care provider with primary practice located at 3512 S Lafountain St , Kokomo IN 46902-3803. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Evans, Clifford J can be contacted via phone (765) 776-3100.

Contact Information

Primary practice address
3512 S Lafountain St Kokomo IN 46902-3803
Phone: (765) 776-3100
Fax: (765) 453-8165
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 1985 Tennessee
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X H0070460 Maryland
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 02003895A Indiana

Profile Details

NPI number 1669521522
LBN Legal business name Evans, Clifford J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Jan 2nd, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669521522 NPPES
Indiana MEDICAID 201066810
Indiana Other P01270939

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