Provider Demographics
NPI:1932200508
Name:EVANS, RICHARD PARKER (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:PARKER
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2519 W 90TH ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66206-1838
Mailing Address - Country:US
Mailing Address - Phone:913-549-3767
Mailing Address - Fax:913-549-3767
Practice Address - Street 1:4301 W MARKHAM ST
Practice Address - Street 2:UAMS #783
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-7101
Practice Address - Country:US
Practice Address - Phone:501-686-8000
Practice Address - Fax:501-526-6562
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN-6708207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR123213001Medicaid
AR51595OtherBCBS
ARN6708OtherTRICARE
AR06020016700OtherQUALCHOICE
AR123213001Medicaid
AR51595Medicare PIN