Evans, Clinton Wilkinson
Evans, Clinton Wilkinson is an individual health care provider with primary practice located at 216 Healthwest Dr , Dothan AL 36303-1942. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Evans, Clinton Wilkinson can be contacted via phone (334) 792-1158.Contact Information
Primary practice address
216 Healthwest Dr
Dothan AL 36303-1942
Phone: (334) 792-1158
Fax: (334) 702-6983
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 22785 | Alabama |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 4563 | Alabama |
Profile Details
| NPI number | 1093799009 |
|---|---|
| LBN Legal business name | Evans, Clinton Wilkinson |
| Credentials | M.D., D.M.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 2nd, 2005 |
| Last updated | Sep 18th, 2012 - about 12 years ago |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093799009 | NPPES |
| Alabama | MEDICAID | 000095652 | |
| Alabama | Other | 51097740 | |
| Alabama | Other | 51095652 | |
| Alabama | Other | 766464 |
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