Provider Demographics
NPI:1003892290
Name:EVANS, PAUL JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:JOHN
Last Name:EVANS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 SE 45TH ST
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480-7226
Mailing Address - Country:US
Mailing Address - Phone:727-735-7575
Mailing Address - Fax:727-892-8420
Practice Address - Street 1:2870 SE 45TH ST
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-7226
Practice Address - Country:US
Practice Address - Phone:727-735-7575
Practice Address - Fax:727-892-8420
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME90771208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
4122038OtherAETNA
0733537OtherCIGNA
FL272204600Medicaid
287091OtherSTAYWELL/HEALTHEASE
FL01229OtherBC/BS
297317OtherAVMED
FLT40667Medicare UPIN