Provider Demographics
NPI:1982960324
Name:EVEN, LORAS R (DO)
Entity Type:Individual
Prefix:DR
First Name:LORAS
Middle Name:R
Last Name:EVEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:6520 SE 14TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50320-1846
Mailing Address - Country:US
Mailing Address - Phone:414-257-8577
Mailing Address - Fax:515-953-2137
Practice Address - Street 1:6520 SE 14TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50320-1846
Practice Address - Country:US
Practice Address - Phone:515-256-4242
Practice Address - Fax:515-953-2137
Is Sole Proprietor?:No
Enumeration Date:2012-04-10
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI61731207Q00000X
IADO-05409207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine