Healthcare Provider Details

I. General information

NPI: 1134455223
Provider Name (Legal Business Name): JAMES THOMAS KURTIS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2009
Last Update Date: 10/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1151 AQUIDNECK AVE SUITE 493
MIDDLETOWN RI
02842-5275
US

IV. Provider business mailing address

1151 AQUIDNECK AVE SUITE 493
MIDDLETOWN RI
02842-5275
US

V. Phone/Fax

Practice location:
  • Phone: 401-683-4403
  • Fax:
Mailing address:
  • Phone: 401-683-4403
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberMD03787
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: