1417027582 NPI number — DR. JASON ALAN HUNTER DC

Table of content: DR. JASON ALAN HUNTER DC (NPI 1417027582)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417027582 NPI number — DR. JASON ALAN HUNTER DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNTER
Provider First Name:
JASON
Provider Middle Name:
ALAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUNTER
Provider Other First Name:
JAY
Provider Other Middle Name:
ALAN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1417027582
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
827 WEST 3RD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MITCHELL
Provider Business Mailing Address State Name:
SD
Provider Business Mailing Address Postal Code:
57301-2435
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
605-999-5176
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2300 WEST HAVENS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MITCHELL
Provider Business Practice Location Address State Name:
SD
Provider Business Practice Location Address Postal Code:
57301-8202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
605-996-3741
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/08/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  1096 , registered in the state of SD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 7604800 , issued by the state of ( SD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 252437 . This is a "MIDLANDS CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 56833 . This is a "SANFORD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 706916 . This is a "ACN GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 17060 . This is a "AVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4993495 . This is a "WELLMARK BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9243762 . This is a "DAKOTACARE" identifier . This identifiers is of the category "OTHER".