Provider Demographics
NPI:1285657098
Name:WITTIG, JAMES G (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:WITTIG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017
Mailing Address - Country:US
Mailing Address - Phone:740-615-1324
Mailing Address - Fax:741-615-1344
Practice Address - Street 1:100 TIPPETT CT
Practice Address - Street 2:SUITE 101
Practice Address - City:SUNBURY
Practice Address - State:OH
Practice Address - Zip Code:43074-8572
Practice Address - Country:US
Practice Address - Phone:740-965-3123
Practice Address - Fax:740-965-9713
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-08-2314-W174400000X
OH35-082314207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2401823Medicaid
4105701Medicare PIN