Evans, Randolph R

Evans, Randolph R is an individual health care provider with primary practice located at 1670 W Main St Ste100, Lebanon TN 37087-1344. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Evans, Randolph R can be contacted via phone (615) 453-5155.

Contact Information

Primary practice address
1670 W Main St Ste100 Lebanon TN 37087-1344
Phone: (615) 453-5155
Fax: (615) 444-5915
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 18805 Tennessee

Profile Details

NPI number 1295733772
LBN Legal business name Evans, Randolph R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2005
Last updated Aug 17th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295733772 NPPES
Tennessee Other 4065401 AETNA PPO
Tennessee Other 1238610001 AETNA PPO
Tennessee Other 180006421 AETNA PPO
Tennessee Other 000089791 AETNA PPO
Tennessee Other 3032849 AETNA PPO
Tennessee Other 000089791 AETNA PPO
Tennessee MEDICAID 3389788 AETNA PPO
Tennessee Other 621298175 AETNA PPO
Tennessee Other 000089791 AETNA PPO
Tennessee Other 186641053 AETNA PPO

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