Provider Demographics
NPI:1417027582
Name:HUNTER, JASON ALAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:ALAN
Last Name:HUNTER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:DR
Other - First Name:JAY
Other - Middle Name:ALAN
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:827 WEST 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-2435
Mailing Address - Country:US
Mailing Address - Phone:605-999-5176
Mailing Address - Fax:
Practice Address - Street 1:2300 WEST HAVENS ST
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-8202
Practice Address - Country:US
Practice Address - Phone:605-996-3741
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD1096111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD7604800Medicaid
252437OtherMIDLANDS CHOICE
56833OtherSANFORD HEALTH
706916OtherACN GROUP
17060OtherAVERA
4993495OtherWELLMARK BCBS
9243762OtherDAKOTACARE
252437OtherMIDLANDS CHOICE
SD7604800Medicaid