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	207R00000X	Internal Medicine Physician	059328	AZ
2	207RC0000X	Cardiovascular Disease Physician	20916	AZ
3	207RC0000X	Cardiovascular Disease Physician	059328	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1497712996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES L EVANS MD

Provider Business Mailing Address
First Line	:	3709 N CAMPBELL AVE STE 201
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85719-1563
Country	:	US
Telephone Number	:	520-838-3540
Fax Number	:	520-325-3526

Provider Business Practice Location Address
First Line	:	5140 E GLENN ST
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85712-1337
Country	:	US
Telephone Number	:	520-838-3540
Fax Number	:	520-325-3526

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	12/07/2021

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Directions to “ JAMES L EVANS MD” Practice Location

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