Provider Demographics
NPI:1477669083
Name:HUNTER, ROBERT GAIL (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:GAIL
Last Name:HUNTER
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 1:5169 SO COTTONWOOD ST #310
Mailing Address - Street 2:
Mailing Address - City:MURRAY
Mailing Address - State:UT
Mailing Address - Zip Code:84107
Mailing Address - Country:US
Mailing Address - Phone:801-507-3444
Mailing Address - Fax:801-507-3443
Practice Address - Street 1:5169 SO COTTONWOOD ST #310
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84107
Practice Address - Country:US
Practice Address - Phone:801-507-3444
Practice Address - Fax:801-507-3443
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT187366-1205207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT10484Medicare UPIN
UTEO4452Medicare PIN