1962714394 NPI number — CAROLINE HUNTER M.S., CCC/SLP

Table of content: CAROLINE HUNTER M.S., CCC/SLP (NPI 1962714394)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962714394 NPI number — CAROLINE HUNTER M.S., CCC/SLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNTER
Provider First Name:
CAROLINE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., CCC/SLP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COLBERT
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
CAROLINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., CCC/SLP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1962714394
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/22/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 11407
Provider Second Line Business Mailing Address:
DEPT #2130, UNIVERSITY PHYSICIANS
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35246-2130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-925-6805
Provider Business Mailing Address Fax Number:
601-926-4971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 N STATE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSON
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39216-4500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-984-5160
Provider Business Practice Location Address Fax Number:
601-984-5085
Provider Enumeration Date:
07/14/2010

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: 235Z00000X , with the licence number:  S3477 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 06408563 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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