Robert Gale Evans, LCSW
Individual provider Active NPI Clinical Social Worker · Fort Knox, KY
NPI 1124145107 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1124145107
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 2713-123 (WI)
- Practice address
- 289 Ireland Ave
Ireland Army Community Hospital Camp Atterbury
Fort Knox, KY 40121-5111 - Phone
- (502) 642-9007
- Fax
- (502) 624-0252
- NPI assigned
- Mar 23, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2713-123 | WI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2713-123 | WI | Yes |
Addresses
Primary practice location
289 Ireland Ave
Ireland Army Community Hospital Camp Atterbury
Fort Knox, KY 40121-5111
Mailing address
4294 S Jordan Dr
MC Farland, WI 53558-9057
Phone (608) 835-5980
Other providers in Fort Knox, KY
- Robert Conrad Egbert Jr.
- David James Ellis
- Lorraine Emory
- Richard Christopher Ennis
- Susan Laryssa Epperson
- Exceptional Eye Care, LLC
- Mitchell Timothy Fackler
- Janis Hinds Flynn
- Andrew Dodd Fortenberry
- Benjamin Tully Foster
All providers in Fort Knox, KY · Clinical Social Worker in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.