Provider Demographics
NPI:1114940939
Name:HUNT, PAUL J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:J
Last Name:HUNT
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2475 GARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:PORT ST JOE
Mailing Address - State:FL
Mailing Address - Zip Code:32456-5265
Mailing Address - Country:US
Mailing Address - Phone:850-227-1276
Mailing Address - Fax:850-227-7587
Practice Address - Street 1:2475 GARRISON AVE
Practice Address - Street 2:
Practice Address - City:PORT ST JOE
Practice Address - State:FL
Practice Address - Zip Code:32456-5265
Practice Address - Country:US
Practice Address - Phone:850-227-1276
Practice Address - Fax:850-227-7587
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME34625174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL03570OtherBLUE CROSS
FL038434800Medicaid