Provider Demographics
NPI:1205822707
Name:EVANS, LUKE T (MD)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:T
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 SOUTHPARK DR
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-5641
Mailing Address - Country:US
Mailing Address - Phone:303-722-8987
Mailing Address - Fax:303-722-2935
Practice Address - Street 1:1001 SOUTHPARK DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-5641
Practice Address - Country:US
Practice Address - Phone:303-722-8987
Practice Address - Fax:303-722-2935
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43182207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO44625511Medicaid
COC81772Medicare PIN