Provider Demographics
NPI:1174678809
Name:FRANK J EVANS, D.O. PC
Entity Type:Organization
Organization Name:FRANK J EVANS, D.O. PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:J
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:405-533-2433
Mailing Address - Street 1:1921 W 6TH AVE STE A
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4204
Mailing Address - Country:US
Mailing Address - Phone:405-533-2433
Mailing Address - Fax:405-533-2434
Practice Address - Street 1:1921 W 6TH AVE STE A
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4204
Practice Address - Country:US
Practice Address - Phone:405-533-2433
Practice Address - Fax:833-623-1821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3259207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100136900BMedicaid
OKG11103Medicare UPIN