Provider Demographics
NPI:1396273330
Name:EVANS, ELIZABETH TEJBLUM (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:TEJBLUM
Last Name:EVANS
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Mailing Address - Street 1:4401 MCAULEY BLVD STE 2200
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8561
Mailing Address - Country:US
Mailing Address - Phone:405-749-7023
Mailing Address - Fax:205-934-2061
Practice Address - Street 1:4401 MCAULEY BLVD STE 2200
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8561
Practice Address - Country:US
Practice Address - Phone:405-749-7023
Practice Address - Fax:205-934-2061
Is Sole Proprietor?:No
Enumeration Date:2017-06-02
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL42265207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology