Provider Demographics
NPI:1376534487
Name:HURTH, JAMES (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:HURTH
Suffix:
Gender:M
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2323 N LAKE DR
Mailing Address - Street 2:ATTN: BEHAVIORAL HEALTH, 7TH FLOOR
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53211-4508
Mailing Address - Country:US
Mailing Address - Phone:414-291-1620
Mailing Address - Fax:414-291-5969
Practice Address - Street 1:2323 N LAKE DR
Practice Address - Street 2:ATTN: BEHAVIORAL HEALTH, 7TH FLOOR
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53211-4508
Practice Address - Country:US
Practice Address - Phone:414-291-1620
Practice Address - Fax:414-291-5969
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI272282084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31372800Medicaid
05606810654OtherAMA
05606810654OtherAMA
WI31372800Medicaid
WI000700108Medicare PIN
E09575Medicare UPIN
AH2272235OtherDEA