Provider Demographics
NPI:1902887516
Name:JONES, EVAN E (PA-C)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:E
Last Name:JONES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1948 KILLEY ST
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23453-3650
Mailing Address - Country:US
Mailing Address - Phone:757-430-3187
Mailing Address - Fax:
Practice Address - Street 1:4092 FOXWOOD DRIVE, SUITE #101
Practice Address - Street 2:EMERGENCY PHYSICIANS OF TIDEWATER, PC
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-686-3508
Practice Address - Fax:757-686-0541
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant