Provider Demographics
NPI:1093808107
Name:HUNTER, SAMUEL FORRESTER (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:FORRESTER
Last Name:HUNTER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 BAKERS BRIDGE AVE
Mailing Address - Street 2:STE 105 PMB240
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-1784
Mailing Address - Country:US
Mailing Address - Phone:615-791-5470
Mailing Address - Fax:615-595-0265
Practice Address - Street 1:150 STEPHEN P YOKICH PKWY STE H
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-3326
Practice Address - Country:US
Practice Address - Phone:615-791-5470
Practice Address - Fax:615-595-0265
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN294102084N0400X, 2084N0600X, 2085N0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYM13997Medicaid
TN3813455Medicaid
TN3813455Medicare ID - Type Unspecified
KYM13997Medicaid