Healthcare Provider Details

I. General information

NPI: 1598779084
Provider Name (Legal Business Name): JAMES DONALD KUTCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 02/20/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 FAIR AVE SUITE A
HONESDALE PA
18431-2108
US

IV. Provider business mailing address

1860 FAIR AVE SUITE A
HONESDALE PA
18431-2108
US

V. Phone/Fax

Practice location:
  • Phone: 570-253-3391
  • Fax: 570-253-1811
Mailing address:
  • Phone: 570-253-3391
  • Fax: 570-253-1811

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD033651E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: