Healthcare Provider Details

I. General information

NPI: 1821215005
Provider Name (Legal Business Name): JAMES MARKHAM EVANS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/09/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3433 NW 56TH, SUITE C-40
OKLAHOMA CITY OK
73112
US

IV. Provider business mailing address

3433 NW 56TH, SUITE C-40
OKLAHOMA CITY OK
73112
US

V. Phone/Fax

Practice location:
  • Phone: 405-945-4741
  • Fax: 888-972-5320
Mailing address:
  • Phone: 405-945-4741
  • Fax: 888-972-5320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number36516
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number26405
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: