Provider Demographics
NPI:1255715520
Name:EVOKE MEDICAL SERVICES, INC
Entity type:Organization
Organization Name:EVOKE MEDICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MS
Authorized Official - First Name:REVAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-702-6111
Mailing Address - Street 1:29488 WOODWARD AVE
Mailing Address - Street 2:SUITE 317
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48072
Mailing Address - Country:US
Mailing Address - Phone:248-818-6669
Mailing Address - Fax:
Practice Address - Street 1:29488 WOODWARD AVE
Practice Address - Street 2:SUITE 317
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-0903
Practice Address - Country:US
Practice Address - Phone:248-818-6669
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-16
Last Update Date:2017-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101016685261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain