Evans, Kenneth
Evans, Kenneth is an sole proprietor health care provider with primary practice located at 637 Royal Ave , Midwest City OK 73130-2710. He recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as his primary health care specialty. Evans, Kenneth can be contacted via phone (405) 733-5396.Contact Information
Primary practice address
637 Royal Ave
Midwest City OK 73130-2710
Phone: (405) 733-5396
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1043546971 |
|---|---|
| LBN Legal business name | Evans, Kenneth |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 28th, 2009 |
| Last updated | Oct 28th, 2009 - about 16 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 | 1043546971 | NPPES |
| Oklahoma | MEDICAID | P080455262 |
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