Provider Demographics
NPI:1467437525
Name:EVANS, GREGORY FRANCIS FELIX (MD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:FRANCIS FELIX
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1900 W PARK DR
Mailing Address - Street 2:PO BOX 456
Mailing Address - City:N WILKESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28659-3563
Mailing Address - Country:US
Mailing Address - Phone:336-927-9209
Mailing Address - Fax:336-667-5918
Practice Address - Street 1:1370 W D ST
Practice Address - Street 2:
Practice Address - City:N WILKESBORO
Practice Address - State:NC
Practice Address - Zip Code:28659-3506
Practice Address - Country:US
Practice Address - Phone:336-251-8048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2009-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK26792085R0202X
NC2000007842085R0202X
CAC520602085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G93651Medicare UPIN