Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 264 | NC |
N | 222Z00000X | Podiatrist | 264 | NC |
N | 213EP1101X | Primary Podiatric Medicine | 264 | NC |
Y | 213ES0103X | Foot & Ankle Surgery | 264 | NC |
N | 213ES0131X | Foot Surgery | 264 | NC |
NPI | 1225189798 |
---|---|
Provider Name | Dr. Joan D. Evans |
First Address | Troy, NC 27371-2849 |
Second Address | Troy, NC 27371-2849 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/01/2007 |
Last Update Date | 16/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0805G | BLUE CROSS BLUE SHIELD (01) | NC |
890805G | (05) | NC |
T82537 | (02) | NC |