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NPI Code Detail

MEDICARE: DR. JULIET JANE-ASHLEY EVANS M.D.

MEDICARE: DR. JULIET JANE-ASHLEY 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
1207P00000XEmergency Medicine Physician036135773IL
2207P00000XEmergency Medicine Physician10855046-1205UT

General Provider Information

NPI Number : 1902192164
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIET JANE-ASHLEY EVANS M.D.
Provider Business Mailing Address
First Line : 1607 E BLAINE AVE
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84105-3802
Country : US
Telephone Number : 847-254-1477
Fax Number :
Provider Business Practice Location Address
First Line : 1034 N 500 W
Second Line :
City : PROVO
State : UT
Zip : 84604-3337
Country : US
Telephone Number : 801-357-7850
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2011
Last Update Date : 08/16/2019

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