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General NPI Number Information
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NPI Number | 1538494513
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Entity Type | Individual
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Provider Name | TYLER JONATHAN EVANS D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/09/2009
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Last Update Date | 07/14/2025
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Provider Practice Location Address
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Address Line | 1805 27TH ST
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2640
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Country | US
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Telephone | 740-356-8117
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Fax | 740-353-1214
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Provider Business Mailing Address
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Address Line | 1735 27TH ST STE B06
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2681
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Country | US
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Telephone | 740-356-8117
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Fax | 740-353-1214
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 05111
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 34.009731
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License Number State | OH
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