Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Evan Dale Theobald, PHARMACIST

Individual provider Pharmacist · NPI 1952497604

Mr. Evan Dale Theobald, PHARMACIST is a Pharmacist in Provo, Utah. Practices as a sole proprietor. Licensed in Nevada and Utah.

Licensed in
NV, UT
In the registry since
2006
Specialties on file
2

Practice location Address checks out

1034 N 500 W
Provo, UT 84604
Phone: (801) 357-7051
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 143869 (UT)
Pharmacist Taxonomy 183500000X · Licence 06547 (NV)

Record details

NPI number1952497604
Entity typeIndividual (Type 1)
GenderMale
Credentials PHARMACIST
Sole proprietorYes
NPI enumeratedOctober 4, 2006
Last updated in NPPESJuly 8, 2007

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