Individual
MR. JAMES D PITTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
100 DEERPATH, CHARLESTON, IL 61920-9427
(217) 345-2727
Mailing address
100 DEERPATH, CHARLESTON, IL 61920-9427
(217) 345-2727
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
85000501
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85000501
STATE OF ILLINOIS LICENSE
IL
Enumeration date
06/06/2008
Last updated
06/06/2008
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