Provider Demographics
NPI:1326138074
Name:HUNT, JUSTIN BAILEY (MD)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:BAILEY
Last Name:HUNT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 740020
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-0020
Mailing Address - Country:US
Mailing Address - Phone:312-733-9730
Mailing Address - Fax:
Practice Address - Street 1:2130 SW 59TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73119-7025
Practice Address - Country:US
Practice Address - Phone:403-303-7555
Practice Address - Fax:405-561-5615
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD4695292084P0800X
RIMD179972084P0800X
NY3011812084P0800X
TN583532084P0800X
TXS11332084P0800X
SC833852084P0800X
WV292642084P0800X
GA801212084P0800X
OH35.1398142084P0800X
NVSP4482084P0800X, 2084P0800X
ARE-43272084P0800X
ALMD387442084P0800X
CODR.00631692084P0800X
OK335152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR158478001Medicaid
AR158478001Medicaid
AR5H776Medicare PIN