MEDICARE: MR. JAMES SUTLIVE ATKINS JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME38666	FL
2	207Y00000X	Otolaryngology Physician	ME0038666	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1255355442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JAMES SUTLIVE ATKINS JR. MD

Provider Business Mailing Address
First Line	:	410 CELEBRATION PLACE
Second Line	:	SUITE 100
City	:	CELEBRATION
State	:	FL
Zip	:	34747-5432
Country	:	US
Telephone Number	:	321-939-3000
Fax Number	:	321-939-3001

Provider Business Practice Location Address
First Line	:	410 CELEBRATION PLACE
Second Line	:	SUITE 100
City	:	CELEBRATION
State	:	FL
Zip	:	34747-5432
Country	:	US
Telephone Number	:	321-939-3000
Fax Number	:	321-939-3001

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2006
Last Update Date	:	05/11/2012

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