Provider Demographics
NPI:1902494560
Name:EVILSIZOR, KARALYN (PHARMD)
Entity Type:Individual
Prefix:
First Name:KARALYN
Middle Name:
Last Name:EVILSIZOR
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 N FOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-2202
Mailing Address - Country:US
Mailing Address - Phone:937-323-1841
Mailing Address - Fax:937-323-1016
Practice Address - Street 1:640 N FOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-2202
Practice Address - Country:US
Practice Address - Phone:937-323-1841
Practice Address - Fax:937-323-1016
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03228020183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist