Evan Earl Dussia II MD PLLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

Legal business name

EVAN EARL DUSSIA II MD PLLC

Practice address

1030 E Lafayette St Ste 4
Tallahassee, FL 32301-4547

Phone

(850) 583-2926

Fax

(850) 792-6043

NPI assigned

Jan 14, 2015

Last updated

Jan 14, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Evan Earl Dussia II, MD

Title

Manager

Phone

(850) 583-2926

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1421193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421193600000",
    "number": "1336538370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 E LAFAYETTE ST",
            "address_2": "SUITE:101",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323014569",
            "telephone_number": "850-583-2696",
            "fax_number": "850-792-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 E LAFAYETTE ST STE 4",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323014547",
            "telephone_number": "850-583-2926",
            "fax_number": "850-792-6043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVAN EARL DUSSIA II MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-14",
        "last_updated": "2015-01-14",
        "status": "A",
        "authorized_official_last_name": "DUSSIA",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "850-583-2926",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "065885500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.