Provider Demographics
NPI:1720150121
Name:STURGIS, JAMES LEWIS (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LEWIS
Last Name:STURGIS
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 1:810 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BALDWIN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66006-3101
Mailing Address - Country:US
Mailing Address - Phone:785-594-6412
Mailing Address - Fax:785-594-6413
Practice Address - Street 1:810 HIGH ST
Practice Address - Street 2:
Practice Address - City:BALDWIN CITY
Practice Address - State:KS
Practice Address - Zip Code:66006-3101
Practice Address - Country:US
Practice Address - Phone:785-594-6412
Practice Address - Fax:785-594-6413
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-24967207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G11565Medicare UPIN