Provider Demographics
NPI:1932512845
Name:EVANS, CLAY CARTER (MD)
Entity type:Individual
Prefix:DR
First Name:CLAY
Middle Name:CARTER
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2000 SW ARCHER ROAD
Mailing Address - Street 2:PO BOX 100289
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0289
Mailing Address - Country:US
Mailing Address - Phone:352-294-5480
Mailing Address - Fax:352-627-4142
Practice Address - Street 1:2000 SW ARCHER ROAD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-2022
Practice Address - Country:US
Practice Address - Phone:352-294-5480
Practice Address - Fax:352-627-4142
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC36971207R00000X, 208M00000X
FLME169088207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC369719Medicaid