Provider Demographics
NPI:1851492581
Name:EVANS, JOHN P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3150 HIGHWAY 153
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:SC
Mailing Address - Zip Code:29673-9498
Mailing Address - Country:US
Mailing Address - Phone:864-295-1231
Mailing Address - Fax:864-295-9927
Practice Address - Street 1:3150 HIGHWAY 153
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:SC
Practice Address - Zip Code:29673-9498
Practice Address - Country:US
Practice Address - Phone:864-295-1231
Practice Address - Fax:864-295-9927
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-05-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC10132207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCF22394Medicare UPIN
SC101320Medicare ID - Type UnspecifiedSC MEDICAID
SCQ246841457Medicare ID - Type UnspecifiedMEDICARE ID