Individual
JASON EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1601 BRIGHAM DR, SUITE 250, PERRYSBURG, OH 43551-7114
(419) 872-7745
(419) 874-7758
Mailing address
1601 BRIGHAM DR, SUITE 250, PERRYSBURG, OH 43551-7114
(419) 872-7745
(419) 874-7758
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35045518
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000141276
ANTHEM
OH
01
—
01-05155
UHC
OH
01
—
03817
PARAMOUNT
OH
01
—
080160101
PARAMOUNT
OH
05
—
2176710
—
OH
01
—
2464534
AETNA
OH
Enumeration date
08/12/2005
Last updated
11/03/2023
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