Provider Demographics
NPI:1225148653
Name:FUGATE, JAMES K JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:K
Last Name:FUGATE
Suffix:JR
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 1:601 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-2231
Mailing Address - Country:US
Mailing Address - Phone:717-851-1405
Mailing Address - Fax:
Practice Address - Street 1:30 W SWARTZVILLE RD
Practice Address - Street 2:
Practice Address - City:REINHOLDS
Practice Address - State:PA
Practice Address - Zip Code:17569-9641
Practice Address - Country:US
Practice Address - Phone:717-484-4347
Practice Address - Fax:717-484-0968
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD053184-L208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0014783040001Medicaid
417574OtherHIGHMARK
PA0014783040001Medicaid
PA50088981OtherCAPITAL BLUE CROSS
417574OtherHIGHMARK
PA50088981OtherCAPITAL BLUE CROSS