Evans, Larry Craig
Evans, Larry Craig is an individual health care provider with primary practice located at 2770 Cortez Ave , Idaho Falls ID 83404-7590. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Evans, Larry Craig can be contacted via phone (208) 522-4000.Contact Information
Primary practice address
2770 Cortez Ave
Idaho Falls ID 83404-7590
Phone: (208) 522-4000
Fax: (208) 528-4254
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | O-0468 | Idaho |
Profile Details
| NPI number | 1669540522 |
|---|---|
| LBN Legal business name | Evans, Larry Craig |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 30th, 2006 |
| Last updated | Aug 14th, 2013 - 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 | 1669540522 | NPPES |
| Idaho | MEDICAID | 808040300 |
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