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General NPI Number Information
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NPI Number | 1093715435
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Entity Type | Individual
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Provider Name | JAMES A EVANSON MD
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Gender | Male
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Dates
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Enumeration Date | 07/28/2005
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Last Update Date | 04/03/2018
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Provider Practice Location Address
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Address Line | 3801 BELLEMEADE AVE STE 330
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City | EVANSVILLE
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State | IN
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Zip | 47714-0113
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Country | US
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Telephone | 812-479-3125
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 13059
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City | BELFAST
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State | ME
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Zip | 04915-4021
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 01048633A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 01048633A
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License Number State | IN
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