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NPI Code Detail

MEDICARE: BILLY JOE EVANS M.D.

MEDICARE: BILLY JOE EVANS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician25779AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1114942422
Entity Type Code : Individual
Provider Name (Legal Business Name) : BILLY JOE EVANS M.D.
Provider Business Mailing Address
First Line : 3815 E BELL RD STE 4500
Second Line :
City : PHOENIX
State : AZ
Zip : 85032-2171
Country : US
Telephone Number : 602-633-3848
Fax Number : 602-633-3841
Provider Business Practice Location Address
First Line : 7330 N 99TH AVE STE 325
Second Line :
City : GLENDALE
State : AZ
Zip : 85307-3022
Country : US
Telephone Number : 480-398-7620
Fax Number : 480-398-7621
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 08/01/2024

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Directions to “ BILLY JOE EVANS M.D.” Practice Location

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