Individual
DR. JASON THOMAS EVANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., D.I.B.C.N.
Contact information
Practice address
732 S WASHINGTON AVE, MADISON, SD 57042-3519
(605) 256-0336
(605) 256-0760
Mailing address
PO BOX 365, MADISON, SD 57042-0365
(605) 256-0336
(605) 256-0760
Taxonomy
Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
SD868
SD
111NN0400X
Neurology Chiropractor
Primary
868
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619173523
GROUP NPI
SD
01
—
1982691911
INDIVIDUAL NPI
SD
01
—
350055130
GROUP PTAN
SD
05
—
7604360
—
SD
01
—
DQ2901
GROUP PTAN
SD
Enumeration date
10/04/2005
Last updated
10/05/2010
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