Provider Demographics
NPI:1023592953
Name:NORWIL, EVAN J (PA-C)
Entity type:Individual
Prefix:
First Name:EVAN
Middle Name:J
Last Name:NORWIL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 E CAMELBACK RD STE G100
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-8312
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4350 E CAMELBACK RD
Practice Address - Street 2:SUITE G100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-8312
Practice Address - Country:US
Practice Address - Phone:602-840-3120
Practice Address - Fax:602-840-3237
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7226363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant