Evans, Jonathan

Evans, Jonathan is an individual health care provider with primary practice located at 12722 Tonkel Rd Ste 102 , Fort Wayne IN 46845-8201. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic, which is considered as his primary health care specialty. Evans, Jonathan can be contacted via phone (260) 739-0300.

Contact Information

Primary practice address
12722 Tonkel Rd Ste 102 Fort Wayne IN 46845-8201
Phone: (260) 739-0300
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X PT010453 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthopedic 2251X0800X 05011654A Indiana

Profile Details

NPI number 1033493622
LBN Legal business name Evans, Jonathan
Credentials DPT
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2011
Last updated Jun 25th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033493622 NPPES
Indiana MEDICAID 201289270

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