1528302346 NPI number — DR. JOHN SPENCER HUNT MD

Table of content: DR. JOHN SPENCER HUNT MD (NPI 1528302346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528302346 NPI number — DR. JOHN SPENCER HUNT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNT
Provider First Name:
JOHN
Provider Middle Name:
SPENCER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HUNT
Provider Other First Name:
JOHN
Provider Other Middle Name:
SPENCER
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1528302346
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
93 RUSTY DUCK LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOZEMAN
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59718-9286
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-556-0738
Provider Business Mailing Address Fax Number:
406-556-0738

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
93 RUSTY DUCK LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOZEMAN
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59718-9286
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-556-0738
Provider Business Practice Location Address Fax Number:
406-556-0738
Provider Enumeration Date:
11/16/2012

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: 207R00000X , with the licence number:  9680 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9680 . This is a "SOCIAL SECURITY NUMBER" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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