Healthcare Provider Details

I. General information

NPI: 1811163165
Provider Name (Legal Business Name): JAMES A BARTLETT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 11/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N ALEXANDER ST
PLANT CITY FL
33563-4303
US

IV. Provider business mailing address

15206 KESTRELCREST CT
LITHIA FL
33547-4817
US

V. Phone/Fax

Practice location:
  • Phone: 813-757-1200
  • Fax:
Mailing address:
  • Phone: 813-447-7594
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME106634
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: