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Contact Information

CHARLES E EVANS III, DO
971 LAKELAND DR STE 1052
JACKSON, MS39216-4609
 Phone: 601-981-9503
 Fax: 601-981-7895
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pulmonary Disease

207RP1001X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for CHARLES E EVANS III · (Male)

NPI # 1326335902
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 07/05/2011
Last updated 03/17/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • MS License # 22904
  • MS Other 22904 STATE MEDICAL LICENSE
Hospital affiliation(s)
  • RIVER OAKS HOSPITAL - (Acute Care)
    1030 RIVER OAKS DRIVE
    FLOWOOD, MS 39232
  • ST DOMINIC-JACKSON MEMORIAL HOSPITAL - (Acute Care)
    969 LAKELAND DR
    JACKSON, MS 39216
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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