Provider Demographics
NPI:1073589701
Name:HUNT, DIANE LS (MD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:LS
Last Name:HUNT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3243 E MURDOCK
Mailing Address - Street 2:SUITE 404
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208
Mailing Address - Country:US
Mailing Address - Phone:316-685-6222
Mailing Address - Fax:316-685-1273
Practice Address - Street 1:3243 E MURDOCK
Practice Address - Street 2:SUITE 404
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208
Practice Address - Country:US
Practice Address - Phone:316-685-6222
Practice Address - Fax:316-685-1273
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS26031208600000X
KS04-26031208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS55709OtherMEDICARE ID
KS100343610AMedicaid
KS100343610AMedicaid