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NPI Code Detail

MEDICARE: JOANNA L EVANS DO

MEDICARE:   JOANNA L EVANS  DO
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 PhysicianR2158AZ
2207Q00000XFamily Medicine Physician006551AZ

General Provider Information

NPI Number : 1598020463
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOANNA L EVANS DO
Provider Business Mailing Address
First Line : 5055 E BROADWAY BLVD STE A100
Second Line :
City : TUCSON
State : AZ
Zip : 85711-3629
Country : US
Telephone Number : 520-382-1205
Fax Number : 520-795-0225
Provider Business Practice Location Address
First Line : 7105 N LA CHOLLA BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85741-3112
Country : US
Telephone Number : 520-547-0611
Fax Number : 520-547-0616
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2012
Last Update Date : 10/07/2019

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Directions to “ JOANNA L EVANS DO” Practice Location

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