Provider Demographics
NPI:1932401460
Name:UTLEY, JAMES HARMON (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HARMON
Last Name:UTLEY
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 1:8535 E 21ST ST N
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67206-2911
Mailing Address - Country:US
Mailing Address - Phone:316-609-2342
Mailing Address - Fax:316-609-2346
Practice Address - Street 1:8535 E 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67206-2911
Practice Address - Country:US
Practice Address - Phone:316-609-2342
Practice Address - Fax:316-609-2346
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-05
Last Update Date:2010-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-17380207P00000X
MOR7121207P00000X
OK24676207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine