Provider Demographics
NPI:1255355442
Name:ATKINS, JAMES SUTLIVE JR (MD)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:SUTLIVE
Last Name:ATKINS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:410 CELEBRATION PLACE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CELEBRATION
Mailing Address - State:FL
Mailing Address - Zip Code:34747-5432
Mailing Address - Country:US
Mailing Address - Phone:321-939-3000
Mailing Address - Fax:321-939-3001
Practice Address - Street 1:410 CELEBRATION PLACE
Practice Address - Street 2:SUITE 100
Practice Address - City:CELEBRATION
Practice Address - State:FL
Practice Address - Zip Code:34747-5432
Practice Address - Country:US
Practice Address - Phone:321-939-3000
Practice Address - Fax:321-939-3001
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME38666174400000X
FLME0038666207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL01394WMedicare ID - Type Unspecified
FLC12998Medicare UPIN