Provider Demographics
NPI:1821215005
Name:EVANS, JAMES MARKHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MARKHAM
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 1:3433 NW 56TH, SUITE C-40
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73112
Mailing Address - Country:US
Mailing Address - Phone:405-945-4741
Mailing Address - Fax:888-972-5320
Practice Address - Street 1:3433 NW 56TH, SUITE C-40
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112
Practice Address - Country:US
Practice Address - Phone:405-945-4741
Practice Address - Fax:888-972-5320
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2021-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ365162085R0202X
OK264052085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200197980AMedicaid
OKP00704882OtherMEDICARE RAILROAD (MPI)
AZ212122Medicaid
AZP00413305OtherRAILROAD MEDICARE
OKP00636136OtherRAILROAD MEDICARE
OKOK403601OtherMEDICARE PTAN
AZI74213Medicare UPIN
OKOK401286Medicare PIN
OK200197980AMedicaid
OKOK401562Medicare PIN
AZP00413305OtherRAILROAD MEDICARE
AZ212122Medicaid
AZZ115220Medicare PIN
OKOK401279Medicare PIN