Provider Demographics
NPI:1124077508
Name:EVANS, LEE ANDREW (MD)
Entity type:Individual
Prefix:
First Name:LEE
Middle Name:ANDREW
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 1:219 W 17TH ST
Mailing Address - Street 2:
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-1911
Mailing Address - Country:US
Mailing Address - Phone:270-886-5141
Mailing Address - Fax:270-885-1877
Practice Address - Street 1:219 W 17TH ST
Practice Address - Street 2:
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-1911
Practice Address - Country:US
Practice Address - Phone:270-886-5141
Practice Address - Fax:270-885-1877
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY46605208800000X
TN50936208800000X
NE23123208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology