Provider Demographics
NPI:1750433348
Name:PITTMAN, JAMES (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:PITTMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 N DUNCAN ST
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38556-3101
Mailing Address - Country:US
Mailing Address - Phone:931-752-7851
Mailing Address - Fax:931-752-7853
Practice Address - Street 1:200 N DUNCAN ST
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:TN
Practice Address - Zip Code:38556-3101
Practice Address - Country:US
Practice Address - Phone:931-752-7851
Practice Address - Fax:931-752-7853
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1537208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNH8818Medicare UPIN
3307666Medicare PIN