MEDICARE: DON ALAN 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	7974	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0004050364	OTHER		AETNA
2	410013838	OTHER		RAILROAD MEDIARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	630817103	OTHER		TAX IDENTIFICATION NO
5	51004303	OTHER	AL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1710969522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DON ALAN EVANS MD

Provider Business Mailing Address
First Line	:	420 LOWELL DR SE
Second Line	:	SUITE 103
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-3754
Country	:	US
Telephone Number	:	256-535-5940
Fax Number	:	256-535-5954

Provider Business Practice Location Address
First Line	:	420 LOWELL DR SE
Second Line	:	SUITE 102
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-3754
Country	:	US
Telephone Number	:	256-535-5976
Fax Number	:	256-535-5953

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

Provider Enumeration Date	:	11/17/2005
Last Update Date	:	09/10/2010

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Directions to “ DON ALAN EVANS MD” Practice Location

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