Basic Information
| Provider Information | |||||||||
| NPI: | 1043212962 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EVANS | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1430 | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228031430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404377989 | ||||||||
| FaxNumber: | 5404377984 | ||||||||
| Practice Location | |||||||||
| Address1: | 3322 EMMAUS RD | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228012685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404332431 | ||||||||
| FaxNumber: | 5404339825 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/11/2005 | ||||||||
| LastUpdateDate: | 03/24/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101026345 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1417027608 | 01 | VA | RMH GROUP NPI | OTHER | VAA101306 | 01 | VA | MEDICARE PTAN | OTHER | 1043212962 | 01 | VA | ANTHEM | OTHER | 0057024000 | 01 | WV | WEST VA MEDICAID | OTHER | 1043212962 | 05 | VA | MEDICAID | 1043212962 | 01 | VA | SOUTHERN HEALTH | OTHER |