Individual
ROBERT M EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Mailing address
1200 N BEAVER ST, PAYER CREDENTIALING, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
AZ 3270
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
084530
—
AZ
01
—
AZ0153120
BCBS AZ
AZ
Enumeration date
04/27/2006
Last updated
05/03/2017
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