Provider Demographics
NPI:1275530297
Name:HUNTS, JOHN (MD PHD)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:
Last Name:HUNTS
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 1:2550 WILLAKENZIE RD
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7865
Mailing Address - Country:US
Mailing Address - Phone:541-434-0922
Mailing Address - Fax:541-434-4369
Practice Address - Street 1:2550 WILLAKENZIE RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7865
Practice Address - Country:US
Practice Address - Phone:541-434-0922
Practice Address - Fax:541-434-4369
Is Sole Proprietor?:No
Enumeration Date:2005-07-05
Last Update Date:2013-12-17
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-04-05
Provider Licenses
StateLicense IDTaxonomies
ORMD19148174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORMD19148OtherLICENSE NUMBER
OR074760Medicaid
ORF82163Medicare UPIN
OR144477Medicare PIN