Individual
DAVID P. EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
280 PATTONSVILLE RD, JACKSON, OH 45640-9452
(740) 395-8805
(740) 395-8855
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 441-1934
(740) 446-5982
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
15253
WV
207R00000X
Internal Medicine Physician
Primary
35-04-4543
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000007676
ANTHEM BCBS
—
01
—
000000181849
UNISON MEDICAID
OH
01
—
001714032
MOUNTAIN STATE BCBS
—
05
—
0083149000
—
WV
01
—
0417838
MOLINA MEDICAID
OH
05
—
0417838
—
OH
01
—
310917085075
CARESOURCE MEDICAID
OH
01
—
C30674
RR MEDICARE
—
Enumeration date
05/25/2006
Last updated
11/16/2010
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