Evans, Kendrix Jermaine
Evans, Kendrix Jermaine is an individual health care provider with primary practice located at 1811 Edwina Dr , Vidalia GA 30474-8963. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Evans, Kendrix Jermaine can be contacted via phone (912) 538-9977.Contact Information
Primary practice address
1811 Edwina Dr
Vidalia GA 30474-8963
Phone: (912) 538-9977
Fax: (912) 538-0770
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 8406595-1205 | Utah |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 301950 | Louisiana |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 21459 | Mississippi |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 83679 | Georgia |
Profile Details
| NPI number | 1831325356 |
|---|---|
| LBN Legal business name | Evans, Kendrix Jermaine |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 10th, 2009 |
| Last updated | Oct 17th, 2019 - about 5 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 | 1831325356 | NPPES |
| Mississippi | MEDICAID | 08771565 | |
| Mississippi | MEDICAID | 2427458 | |
| Mississippi | MEDICAID | 003221715A |
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