Provider Demographics
NPI:1114434271
Name:EVANS, JOHN TROY (PA-C)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:TROY
Last Name:EVANS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9040 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:JOINT BASE LEWIS-MCCHORD
Mailing Address - State:NY
Mailing Address - Zip Code:98431
Mailing Address - Country:US
Mailing Address - Phone:253-968-5496
Mailing Address - Fax:
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:JOINT BASE LEWIS MCCHORD
Practice Address - State:WA
Practice Address - Zip Code:98431-5438
Practice Address - Country:US
Practice Address - Phone:253-968-5496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-10
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant