Provider Demographics
NPI:1376982199
Name:EVANS, ANDREW MARK (DPM)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:MARK
Last Name:EVANS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:754 S MAIN ST STE 3
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-5505
Mailing Address - Country:US
Mailing Address - Phone:435-628-2671
Mailing Address - Fax:
Practice Address - Street 1:754 S MAIN ST STE 3
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-5505
Practice Address - Country:US
Practice Address - Phone:435-628-2671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDP191824213E00000X
TXT46-2013213ES0103X
UT9854057-0501213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery