Dr Van Evanoff Jr, MD is a
Pain Medicine - Interventional Pain Medicine physician based in Sullivan, Indiana. Dr Van Evanoff Jr is licensed to practice in Indiana (license number 01053652A) and his current practice location is 2204 N Section St, Suite B, Sullivan, Indiana. He can be reached at his office (for appointments etc.) via phone at
(812) 268-2556.
NPI number for Dr Van Evanoff Jr is 1851394175 and his current mailing address is 2204 N Section St Po Box 10, Suite B, Sullivan, Indiana. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1851394175.
Physician's Profile
| Full Name | Dr Van Evanoff Jr |
|---|
| Gender | Male |
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| Speciality | Pain Medicine - Interventional Pain Medicine |
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| Location | 2204 N Section St, Sullivan, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1851394175
- Provider Enumeration Date: 05/31/2005
- Last Update Date: 05/25/2016
Medical Identifiers
Medical identifiers for Dr Van Evanoff Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1851394175 | NPI | - | NPPES |
| 000000338733 | Other | IN | BLUE CROSS & BLUE SHIELD |
| 200262220 | Medicaid | IN | |
| P01625340 | Other | IN | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 01053652A (Indiana) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Van Evanoff Jr is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Van Evanoff Jr, MD
2204 N Section St Po Box 10, Suite B,
Sullivan, IN 47882-0010
Ph: (812) 268-2556 | Dr Van Evanoff Jr, MD
2204 N Section St, Suite B,
Sullivan, IN 47882-0010
Ph: (812) 268-2556 |
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