Jeffrey L Evans, MD

Individual provider Active NPI Family Medicine Physician · Mansfield, LA

NPI 1528047008 · NPPES record last updated Aug 6, 2013

Key facts

NPI
1528047008
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
:016326 (LA)
Practice address
130 Jefferson Street
Mansfield, LA 71052
Phone
(318) 872-2700
Fax
(318) 872-6214
NPI assigned
Jan 12, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
HHS exclusion list flag
The National Provider Directory flags this NPI as appearing on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
:016326LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Desoto Hospital Association Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X :016326 LA Yes

Addresses

Primary practice location

130 Jefferson Street
Mansfield, LA 71052

Mailing address

PO Box 740
Mansfield, LA 71052
Phone (318) 872-2700

Other identifiers

IdentifierTypeStateIssuer
721417526EVOtherOCHSNERS
B63077OtherSTERLING OPTION 1
1325961MedicaidLA
080120718OtherRAILROAD MEDICARE
430921723BOtherLABCBS

Other providers in Mansfield, LA

All providers in Mansfield, LA · Family Medicine Physician in Louisiana

Sources for this page

Verify at the official NPI Registry.