Provider Demographics
NPI:1992795868
Name:EVANS, ARTHUR T (MD)
Entity type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:T
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 1:2830 VICTORY PKWY
Mailing Address - Street 2:SUITE 140
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45206-1785
Mailing Address - Country:US
Mailing Address - Phone:513-245-3113
Mailing Address - Fax:513-245-3110
Practice Address - Street 1:PERINATAL TREATMENT CENTER
Practice Address - Street 2:234 GOODMAN STREET
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-0001
Practice Address - Country:US
Practice Address - Phone:513-584-4800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-24
Last Update Date:2012-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7722207V00000X, 207VM0101X
OH35-037515207VC0200X, 207V00000X, 207VM0101X
KY35926207VC0200X, 207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VC0200XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2350763Medicaid
TX129185101Medicaid
KY64005101Medicaid
TX156411402Medicaid
A37214Medicare UPIN
OH2350763Medicaid
KY64005101Medicaid