Provider Demographics
NPI:1588826887
Name:HUNTER, SCOTT R (BA DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:HUNTER
Suffix:
Gender:M
Credentials:BA DC
Other - Prefix:DR
Other - First Name:S
Other - Middle Name:R
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:439 PRAIRIE VIEW PLACE STE D
Mailing Address - Street 2:DR S R HUNTER
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716
Mailing Address - Country:US
Mailing Address - Phone:307-682-6650
Mailing Address - Fax:
Practice Address - Street 1:439 PRAIRIE VIEW PLACE STE D
Practice Address - Street 2:DR S R HUNTER
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716
Practice Address - Country:US
Practice Address - Phone:307-682-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY355111N00000X
ND519111N00000X
CO2138111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
841385278OtherTAX ID NUMBER
WY305870Medicare UPIN