Provider Demographics
NPI:1417941022
Name:HUNT, JOE W (MD)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:W
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 1:202 TUCKER AVE
Mailing Address - Street 2:
Mailing Address - City:RIPLEY
Mailing Address - State:TN
Mailing Address - Zip Code:38063-1631
Mailing Address - Country:US
Mailing Address - Phone:731-287-4500
Mailing Address - Fax:731-287-4804
Practice Address - Street 1:202 TUCKER AVE
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-1631
Practice Address - Country:US
Practice Address - Phone:731-635-4741
Practice Address - Fax:731-635-3466
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-09
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000013611207Q00000X
TNMD013611207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
080056360OtherPALMETTO GBA
7151OtherTLC (MEMPHIS MAN. CARE)
4025313OtherAETNA
0198620OtherBLUE CROSS
0140415OtherUNITED HEALTHCARE
116252OtherBETTER HEALTH PLAN
7781038OtherCIGNA
TN3001790Medicaid
TN0198620OtherBLUE CROSS
116252OtherBETTER HEALTH PLAN
0140415OtherUNITED HEALTHCARE