Healthcare Provider Details

I. General information

NPI: 1285657098
Provider Name (Legal Business Name): JAMES G WITTIG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 01/14/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 TIPPETT CT SUITE 101
SUNBURY OH
43074-8572
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017
US

V. Phone/Fax

Practice location:
  • Phone: 740-965-3123
  • Fax: 740-965-9713
Mailing address:
  • Phone: 740-615-1324
  • Fax: 741-615-1344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number35-08-2314-W
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-082314
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: