Provider Demographics
NPI:1396011961
Name:EVANS, PATRICIA JEAN (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:JEAN
Last Name:EVANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PAT
Other - Middle Name:
Other - Last Name:EVANS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:P.O. BOX 1168
Mailing Address - Street 2:281 OVERTURF RD.
Mailing Address - City:DARBY
Mailing Address - State:MT
Mailing Address - Zip Code:59829
Mailing Address - Country:US
Mailing Address - Phone:406-821-1200
Mailing Address - Fax:
Practice Address - Street 1:702 S.W. HIGGINS
Practice Address - Street 2:FIRST CHOICE MEDICAL CLINIC
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804
Practice Address - Country:US
Practice Address - Phone:406-721-9543
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-28
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6961MONTANA207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine