Provider Demographics
NPI:1598779084
Name:KUTCH, JAMES DONALD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DONALD
Last Name:KUTCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1860 FAIR AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:HONESDALE
Mailing Address - State:PA
Mailing Address - Zip Code:18431-2108
Mailing Address - Country:US
Mailing Address - Phone:570-253-3391
Mailing Address - Fax:570-253-1811
Practice Address - Street 1:1860 FAIR AVE
Practice Address - Street 2:SUITE A
Practice Address - City:HONESDALE
Practice Address - State:PA
Practice Address - Zip Code:18431-2108
Practice Address - Country:US
Practice Address - Phone:570-253-3391
Practice Address - Fax:570-253-1811
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD033651E207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
0015329OtherGHI
PA804252OtherFIRST PRIORITY
9013796OtherPHCS
PA0010038110003Medicaid
PAKU133381OtherHIGHMARK BLUE SHIELD
0066723000OtherAMERIHEALTH
PA0010038110007Medicaid
11244OtherGEISENGER
PA804252OtherFIRST PRIORITY
0066723000OtherAMERIHEALTH
133381DX1Medicare ID - Type Unspecified