Provider Demographics
NPI:1033194360
Name:ARTERBURN, JAMES G (M D)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:G
Last Name:ARTERBURN
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 47948
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33743-7948
Mailing Address - Country:US
Mailing Address - Phone:727-793-9300
Mailing Address - Fax:
Practice Address - Street 1:1501 PASADENA AVE S
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:FL
Practice Address - Zip Code:33707-3717
Practice Address - Country:US
Practice Address - Phone:727-381-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-09
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME233262085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL300017095OtherRR MCR
FL71752OtherBCBS
FL047024400Medicaid
FL71752OtherBCBS
FL71752XMedicare PIN
FL047024400Medicaid