Provider Demographics
NPI:1174818165
Name:EVANS, JOE THOMAS (BS PHARMACY)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:THOMAS
Last Name:EVANS
Suffix:
Gender:M
Credentials:BS PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 NOLEN LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37064-6222
Mailing Address - Country:US
Mailing Address - Phone:615-218-4652
Mailing Address - Fax:
Practice Address - Street 1:3205 NOLEN LN
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-6222
Practice Address - Country:US
Practice Address - Phone:615-218-4652
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2228183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist