Doctor Name: | MR. WILLIAM GRAHAM EVANS |
NPI Number: | 1952397101 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PAC |
License Number: | 39759 |
Business Practice Address: | 1224 E Main St Havelock, NC - 285322405 |
Business Phone Number: | 2524477474 |
Business Fax Number: | 2524471050 |
Mailing Address: | 143 Lola Ln, MOREHEAD CITY |
State: | NC |
Postal Code: | 285578925 |
Phone Number: | 2527262114 |
Fax Number: | |
NPI Enumeration Date: | 09/23/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 39759 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |