DR. EVAN G BLACK (NPI# 1346260247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346260247 |
| Entity Type | Individual |
| Full Name | DR. EVAN G BLACK |
| Credential | M.D. |
| Practice Address |
5323 Woodrow St #201 Murray UT 84107-5841 |
| Practice Telephone | 8012614711 |
| Practice Fax Number | 8012614769 |
| Mailing Telephone | 8012614711 |
| Mailing Fax Number | 8012614769 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-10-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
187597-1205 | UT | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932185089 | Evan H Black | Ophthalmology | 4717 St. Antoine, Kresge Eye Institute, Detroit, MI 48201-1423 | 2005-12-21 |
| 1316599020 | Evan Michael Black | Dentist | 200 Mercy Cir, Building H-200 4th Floor, Fpo, AA 92055 | 2019-07-12 |
| Street Address |
5323 WOODROW ST #201 |
| City | MURRAY |
| State | UT |
| Zip Code | 84107-5841 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023313020 | Breawn Rizzuto | Nurse Practitioner | 5323 Woodrow St, Suite #102, Murray, UT 84107-5841 | 2011-01-21 |
| 1447562764 | Christopher Davis | Physician Assistant | 5323 Woodrow St, Suite 200, Murray, UT 84107-5841 | 2010-07-02 |
| 1205083763 | Rachel Dresher Gurr | Physician Assistant | 5323 Woodrow St, Murray, UT 84107-5841 | 2008-08-26 |
| 1992828958 | Kayleen Terry | Nurse Practitioner | 5323 Woodrow St, Ste 102, Murray, UT 84107-5841 | 2007-04-06 |
| 1104910355 | Sleep Institute of Utah Lc | Clinic/Center | 5323 Woodrow St, Ste 205, Murray, UT 84107-5841 | 2006-10-03 |
| 1174543060 | Diana D. Banks | Psychiatry & Neurology | 5323 Woodrow St, #201, Murray, UT 84107-5841 | 2006-07-20 |
| 1427005586 | Mmps Murray | Clinic/Center | 5323 Woodrow St, Murray, UT 84107-5841 | 2006-05-27 |
| 1730138629 | Maya Thomas | Psychiatry & Neurology | 5323 Woodrow St, Murray, UT 84107-5851 | 2006-05-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 2084N0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology |
| A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144280454 | Alan Goldman | Psychiatry & Neurology | 5810 S 300 E, # 300, Murray, UT 84107-6178 | 2006-03-23 |
| 1447221478 | Pramit Bhasin | Psychiatry & Neurology | 300 S 8th St Ste 301e, Murray, KY 42071-2403 | 2006-01-28 |
| 1821435058 | Kathleen E Mckee | Psychiatry & Neurology | 5171 S Cottonwood St Ste 810, Murray, UT 84107 | 2013-05-29 |
| 1285991208 | Cory Kogelschatz | Psychiatry & Neurology | 5171 S Cottonwood St Ste 810, Murray, UT 84107-5705 | 2012-04-15 |
| 1831476308 | Ihc Health Services Inc | Psychiatry & Neurology | 5171 Cottonwood St, Ste 810, Murray, UT 84107-5705 | 2011-11-10 |
| 1053600858 | Marilyn Jean Mckasson | Psychiatry & Neurology | 5171 S Cottonwood St Ste 810, Murray, UT 84107 | 2011-04-01 |
| 1316252802 | Neeta Lal | Psychiatry & Neurology | 5171 S Cottonwood St, Suite 810, Murray, UT 84107-5704 | 2010-08-10 |
| 1992017800 | Glen Thomas Robinson | Psychiatry & Neurology | 5121 S Cottonwood St, Murray, UT 84107-5701 | 2010-07-08 |
| 1730405408 | Alex Jonathan Nelson | Psychiatry & Neurology | 5801 S Fashion Blvd, Ste. 180, Murray, UT 84107-6159 | 2010-04-20 |
| 1083938567 | Western Kentucky Neurology Inc | Psychiatry & Neurology | 300 S 8th St, Suite 282 West, Murray, KY 42071-2400 | 2010-03-26 |
| Find all providers in MURRAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.