Provider Demographics
NPI:1659773562
Name:BEATTY, JAMES KUHLMAN JR (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:KUHLMAN
Last Name:BEATTY
Suffix:JR
Gender:M
Credentials:PA-C
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:KUHLMAN
Other - Last Name:BEATTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:975 W. FARIS RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29605
Mailing Address - Country:US
Mailing Address - Phone:864-729-8330
Mailing Address - Fax:864-751-0479
Practice Address - Street 1:975 W. FARIS RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605
Practice Address - Country:US
Practice Address - Phone:864-729-8330
Practice Address - Fax:864-751-0479
Is Sole Proprietor?:No
Enumeration Date:2014-09-23
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9108267363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant