Provider Demographics
NPI:1275725137
Name:JOHN B. HUNT, M.D., P.C.
Entity Type:Organization
Organization Name:JOHN B. HUNT, M.D., P.C.
Other - Org Name:ADULT & PEDIATRIC UROLOGY, P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:229-333-0003
Mailing Address - Street 1:PO BOX 3877
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31604-3877
Mailing Address - Country:US
Mailing Address - Phone:229-333-0003
Mailing Address - Fax:229-333-0087
Practice Address - Street 1:2704 N OAK ST
Practice Address - Street 2:BUILDING A-2
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1744
Practice Address - Country:US
Practice Address - Phone:229-333-0003
Practice Address - Fax:229-333-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA17828208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD45719Medicare UPIN