Provider Demographics
NPI:1134455223
Name:KURTIS, JAMES THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:THOMAS
Last Name:KURTIS
Suffix:
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 1:1151 AQUIDNECK AVE
Mailing Address - Street 2:SUITE 493
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-5275
Mailing Address - Country:US
Mailing Address - Phone:401-683-4403
Mailing Address - Fax:
Practice Address - Street 1:1151 AQUIDNECK AVE
Practice Address - Street 2:SUITE 493
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842-5275
Practice Address - Country:US
Practice Address - Phone:401-683-4403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD03787207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI229006329Medicare PIN