MEDICARE: JAMES L EVANS MD

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
1	2084P0800X	Psychiatry Physician	0101040913	VA

General Provider Information

NPI Number	:	1154329886
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES L EVANS MD

Provider Business Mailing Address
First Line	:	PO BOX 91734
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23291-1734
Country	:	US
Telephone Number	:	804-358-6100
Fax Number	:	804-342-7619

Provider Business Practice Location Address
First Line	:	1250 E MARSHALL ST
Second Line	:	PSYCHIATRY
City	:	RICHMOND
State	:	VA
Zip	:	23298-5051
Country	:	US
Telephone Number	:	804-828-3129
Fax Number	:	804-828-7814

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	04/15/2008

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