Provider Demographics
NPI:1194727743
Name:HURT, JAMES D (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:D
Last Name:HURT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 DUTCHMANS PKWY
Mailing Address - Street 2:STE 125
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40205-3342
Mailing Address - Country:US
Mailing Address - Phone:502-896-8700
Mailing Address - Fax:502-896-0813
Practice Address - Street 1:1169 EASTERN PKWY STE 1211
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40217-1462
Practice Address - Country:US
Practice Address - Phone:502-896-8700
Practice Address - Fax:502-960-8138
Is Sole Proprietor?:No
Enumeration Date:2005-08-12
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002127B152WC0802X
KY1055DT152WC0802X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
2200092OtherUNITED HEALTHCARE
K001342OtherTRICARE KENTUCKY OFFICE
911283OtherBLOCK VISION
KY000000042390OtherANTHEM
200189590AOtherMEDICAID MADISON OFFICE
IN410024957OtherMEDICARE RAILROAD
IN000000062215OtherANTHEM
K001342OtherTRICARE INDIANA OFFICE
KY1061182OtherMEDICAID PASSPORT
200189590BOtherMEDICAID LOUISVILLEOFFICE
KY410010011OtherMEDICARE RAILROAD
4672263OtherAETNA
KY77010551Medicaid