| John Edward Evans, MD | |
|
901 Wallace Ave, Leitchfield, KY 42754-1417 | |
| (270) 259-5641 | |
| (270) 259-5309 |
| Full Name | John Edward Evans |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 901 Wallace Ave, Leitchfield, Kentucky |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952358889 | NPI | - | NPPES |
| 64082829 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 38545 (Kentucky) | Primary |
| Entity Name | Leitchfield Pediatric Clinic P.s.c. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558318543 PECOS PAC ID: 9234187808 Enrollment ID: O20091117000437 |
| Mailing Address | Practice Location Address |
|---|---|
| John Edward Evans, MD 901 Wallace Ave, Leitchfield, KY 42754-1417 Ph: (270) 259-5641 | John Edward Evans, MD 901 Wallace Ave, Leitchfield, KY 42754-1417 Ph: (270) 259-5641 |
Ms. Wendee Marie Embry, MS, PA-C Pediatrics Medicare: Medicare Enrolled Practice Location: 901 Wallace Ave, Leitchfield, KY 42754 Phone: 270-259-5641 Fax: 270-259-5309 | |
Tara Meredith, APRN Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 718 Goodwin Ln, Leitchfield, KY 42754 Phone: 731-394-1145 | |
Joseph Marion Lee, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 901 Wallace Ave, Leitchfield, KY 42754 Phone: 270-259-5641 Fax: 270-259-5309 | |
Jessika Young Purcell, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 901 Wallace Ave, Leitchfield, KY 42754 Phone: 270-259-5641 Fax: 270-259-5309 |