Provider Demographics
NPI:1225099575
Name:PITTS, JAMES R (PA-C)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:PITTS
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:PO BOX 11396
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4004
Mailing Address - Country:US
Mailing Address - Phone:877-848-1463
Mailing Address - Fax:615-469-6677
Practice Address - Street 1:1111 12TH ST STE 207
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-3007
Practice Address - Country:US
Practice Address - Phone:305-295-3477
Practice Address - Fax:305-295-3550
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLPA9115873363A00000X
CO545363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCO301323Medicare PIN