Provider Demographics
NPI:1043214463
Name:O'TOOLE, JAMES DENNIS (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:DENNIS
Last Name:O'TOOLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 CENTRE AVE
Mailing Address - Street 2:STE 703
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15232-1327
Mailing Address - Country:US
Mailing Address - Phone:412-687-8300
Mailing Address - Fax:412-687-8391
Practice Address - Street 1:5200 CENTRE AVE
Practice Address - Street 2:STE 703
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15232-1327
Practice Address - Country:US
Practice Address - Phone:412-687-8300
Practice Address - Fax:412-687-8391
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012868E207RC0000X
MO30568207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0007965470004Medicaid
WV0178211000Medicaid
140966Medicare ID - Type Unspecified
B39072Medicare UPIN