Provider Demographics
NPI:1407844202
Name:HUNT, MARION GLENN (MD)
Entity Type:Individual
Prefix:DR
First Name:MARION
Middle Name:GLENN
Last Name:HUNT
Suffix:
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 1:1204 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-5326
Mailing Address - Country:US
Mailing Address - Phone:662-236-5717
Mailing Address - Fax:662-234-4016
Practice Address - Street 1:1204 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5326
Practice Address - Country:US
Practice Address - Phone:662-236-5717
Practice Address - Fax:662-234-4016
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-06
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS9976207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS160013559OtherRAILROAD MEDICARE
MS00017320Medicaid
MSD00681Medicare UPIN
MS160013559OtherRAILROAD MEDICARE