Keith Allen Evans in Bloomington - Endodontics
Keith Allen Evans - NPI 1215009923
Keith Allen Evans is a Endodontics in Bloomington, Illinois. Keith Allen Evans practices all healthcare services and medical treatments related to Endodontics. The NPI Number for Keith Allen Evans is 1215009923. The last update date is 2014-03-12.
Keith Allen Evans's current location address is 113 N Regency Dr, Bloomington, Illinois. You can contact this provider via phone number 3096618900 and fax number 3096618118. The mailing address for Keith Allen Evans is 113 N Regency Dr, Bloomington, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Keith Allen Evans |
|---|---|
| Address | 113 N Regency Dr, Bloomington, Illinois |
| Phone Number | 3096618900 |
| Fax Number | 3096618118 |
| Sole Proprietor | Y |
| Credentials | D.M.D., M. |
NPI Number Detail
| NPI Number | 1215009923 |
|---|---|
| Provider Enumeration Date | 2006-11-15 |
| Last Updated Date | 2014-03-12 |
Provider Mailing Address Detail
| Address | 113 N Regency Dr |
|---|---|
| City | Bloomington |
| State | Illinois (IL) |
| Post Code | 617013515 |
| Phone Number | 3096618900 |
| Fax Number | 3096618118 |
Provider's Primary Taxonomy Detail
| Speciality | Endodontics |
|---|---|
| Taxonomy | 1223E0200X |
| Licence No | 021-002108 |
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Definition: The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the eti |
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What is the unique 10-digit identification code issued to Keith Allen Evans by the Centers for Medicare & Medicaid Services?
The Keith Allen Evans has been assigned the NPI (National Provider Identifier) 1215009923 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical location address where Keith Allen Evans's facilities are situated?
The facilities of Keith Allen Evans are physically located at the following address: 113 N Regency Dr, Bloomington, IL, 617013515.
What is Keith Allen Evans's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Keith Allen Evans's specialized field of practice is Endodontics, and the corresponding taxonomy code that categorizes this area of specialization is 1223E0200X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1215009923 to Keith Allen Evans?
The Centers for Medicare & Medicaid Services originally issued the 1215009923 to Keith Allen Evans on 2006-11-15.
When was the Keith Allen Evans's information last updated?
The Keith Allen Evans's information was last updated on 2014-03-12.