Provider Demographics
NPI:1730462797
Name:EVANS, RICHARD (NONE) III (RICHARD EVANS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:(NONE)
Last Name:EVANS
Suffix:III
Gender:M
Credentials:RICHARD EVANS
Other - Prefix:DR
Other - First Name:RICHARD
Other - Middle Name:(NONE)
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DICK EVANS
Mailing Address - Street 1:184 BAY RD
Mailing Address - Street 2:
Mailing Address - City:BOWDOINHAM
Mailing Address - State:ME
Mailing Address - Zip Code:04008-4010
Mailing Address - Country:US
Mailing Address - Phone:207-666-3927
Mailing Address - Fax:
Practice Address - Street 1:184 BAY RD
Practice Address - Street 2:
Practice Address - City:BOWDOINHAM
Practice Address - State:ME
Practice Address - Zip Code:04008-4010
Practice Address - Country:US
Practice Address - Phone:207-666-3927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-26
Last Update Date:2011-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME0061682084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry