Provider Demographics
NPI:1508095753
Name:HUNTER, CRAIG BRENT (DO)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:BRENT
Last Name:HUNTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7150 W SUNSET RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-1982
Mailing Address - Country:US
Mailing Address - Phone:702-508-3677
Mailing Address - Fax:702-508-3677
Practice Address - Street 1:3150 N TENAYA WAY STE 480
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0494
Practice Address - Country:US
Practice Address - Phone:702-577-0024
Practice Address - Fax:702-608-4737
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVDO1904208800000X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV110441Medicare PIN