Provider Demographics
NPI:1154629905
Name:HUNT VISION GROUP P.C.
Entity Type:Organization
Organization Name:HUNT VISION GROUP P.C.
Other - Org Name:HUNT VISION GROUP P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMRON
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:573-714-2075
Mailing Address - Street 1:1001 N LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:DONIPHAN
Mailing Address - State:MO
Mailing Address - Zip Code:63935-1256
Mailing Address - Country:US
Mailing Address - Phone:573-714-2075
Mailing Address - Fax:
Practice Address - Street 1:1001 N LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:DONIPHAN
Practice Address - State:MO
Practice Address - Zip Code:63935-1256
Practice Address - Country:US
Practice Address - Phone:573-714-2075
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-03
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010003758152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty