Individual provider · Type 1 NPI
Mark A. Evans, PA-C
General Practice Physician · Grainte, OK
NPI number
1205928983
Active
Practice location
417 N Main
Grainte, OK 73547
Fax (877) 785-6691
Mailing address
PO Box 476
Granite, OK 73547
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 802 (OK) |
| General Practice Physician Primary | 208D00000X | OK802 (OK) |
General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
About NPI 1205928983
Mark A. Evans, PA-C's National Provider Identifier is 1205928983, issued on Sep 29, 2006. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Grainte, OK. The record was last updated on Aug 22, 2024.