Provider Demographics
NPI:1083616585
Name:EVANS, JOHN BRECKINRIDGE III (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BRECKINRIDGE
Last Name:EVANS
Suffix:III
Gender:M
Credentials:PHARMD
Other - Prefix:
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Mailing Address - Street 1:4319 SAINT OLAF CIR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-9460
Mailing Address - Country:US
Mailing Address - Phone:270-827-3045
Mailing Address - Fax:812-485-7454
Practice Address - Street 1:3700 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47750-0001
Practice Address - Country:US
Practice Address - Phone:812-485-6722
Practice Address - Fax:812-485-7454
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016234A1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy