Provider Demographics
NPI:1114118213
Name:EVANS, JOSEPH J (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:EVANS
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:1 ORTHOPEDICS DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PEABODY
Mailing Address - State:MA
Mailing Address - Zip Code:01960-1668
Mailing Address - Country:US
Mailing Address - Phone:978-818-6350
Mailing Address - Fax:978-818-6355
Practice Address - Street 1:1 ORTHOPEDICS DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PEABODY
Practice Address - State:MA
Practice Address - Zip Code:01960-1668
Practice Address - Country:US
Practice Address - Phone:978-818-6350
Practice Address - Fax:978-818-6355
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2010-10-21
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Provider Licenses
StateLicense IDTaxonomies
MA233273207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA000469803OtherMEDICARE PTAN