Healthcare Provider Details

I. General information

NPI: 1508800707
Provider Name (Legal Business Name): JAMIE SUZETTE EVANS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 03/02/2026
Certification Date: 03/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506B HIGHWAY 65 N
MC GEHEE AR
71654-9407
US

IV. Provider business mailing address

PO BOX 169
MC GEHEE AR
71654-0169
US

V. Phone/Fax

Practice location:
  • Phone: 870-222-8637
  • Fax: 870-292-3504
Mailing address:
  • Phone: 870-222-8637
  • Fax: 870-292-3504

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number23396
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberE12437
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: