Provider Demographics
NPI:1780685438
Name:FITTS, JAMES MORGAN JR (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:MORGAN
Last Name:FITTS
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 1:508 AUTUMN SPRINGS CT
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-8272
Mailing Address - Country:US
Mailing Address - Phone:615-628-8852
Mailing Address - Fax:615-628-8869
Practice Address - Street 1:508 AUTUMN SPRINGS CT
Practice Address - Street 2:SUITE 1B
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8272
Practice Address - Country:US
Practice Address - Phone:615-628-8852
Practice Address - Fax:615-628-8869
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-03
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4878174400000X
TN0000004878208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1031343172OtherMEDICARE, PTAN
TN2005326OtherBLUE CROSS BLUE SHIELD TN
TNP00968800OtherMEDICARE RR
TNB02174Medicare UPIN
TN2005326OtherBLUE CROSS BLUE SHIELD TN
TN340013814Medicare PIN