Provider Demographics
NPI:1568462521
Name:HUNTER, JAMES KEITH JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KEITH
Last Name:HUNTER
Suffix:JR
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:PO BOX 4046
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65808-4046
Mailing Address - Country:US
Mailing Address - Phone:417-269-2215
Mailing Address - Fax:417-269-2427
Practice Address - Street 1:1741 S 15TH ST
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-9030
Practice Address - Country:US
Practice Address - Phone:417-269-2215
Practice Address - Fax:417-269-2427
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2013-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR2A41207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO940868OtherFIRST HEALTH
MO940868OtherCENTRAL RESERVE LIFE
MO1378074OtherUNITED HEALTH CARE
MO201280609Medicaid
NE44053782613OtherNEBRASKA MEDICAID
MO08481-016OtherBLUE CROSS BLUE SHIELD
MO10001183400OtherCOMMUNITY HEALTH PLAN
IA1904839OtherIOWA MEDICAID
MOD90222Medicare UPIN