Provider Demographics
NPI:1174622864
Name:EVANS, FRANCES RUSSELL (MD)
Entity type:Individual
Prefix:MRS
First Name:FRANCES
Middle Name:RUSSELL
Last Name:EVANS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 W PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6365
Mailing Address - Country:US
Mailing Address - Phone:540-723-6660
Mailing Address - Fax:540-723-6688
Practice Address - Street 1:1824 W PLAZA DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6365
Practice Address - Country:US
Practice Address - Phone:540-723-6660
Practice Address - Fax:540-723-6688
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049881207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA110214315OtherMEDICARE RR
WV2000086000Medicaid
VA1174622864Medicaid
VA110007942Medicare PIN
VAF88901Medicare UPIN