Individual
DR. JAMES A EVANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3801 BELLEMEADE AVE STE 330, EVANSVILLE, IN 47714-0113
(812) 479-3125
Mailing address
PO BOX 13059, BELFAST, ME 04915-4021
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01048633A
IN
207RN0300X
Nephrology Physician
Primary
01048633A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200183300
—
IN
01
—
392107
MEDICARE
KY
01
—
5258690
AETNA
—
05
—
64881295
—
KY
01
—
86204
COVENTRY CARE
KY
01
—
930005675
RAILROAD MEDICARE
IN
Enumeration date
07/28/2005
Last updated
04/03/2018
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