Provider Demographics
NPI:1598922346
Name:FUNCTIONAL & NUTRITIONAL MEDICINE, P.C.
Entity Type:Organization
Organization Name:FUNCTIONAL & NUTRITIONAL MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:H
Authorized Official - Middle Name:HUNTER
Authorized Official - Last Name:YOST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-219-5060
Mailing Address - Street 1:6993 N ORACLE RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-4224
Mailing Address - Country:US
Mailing Address - Phone:520-219-5060
Mailing Address - Fax:520-219-2993
Practice Address - Street 1:6993 N ORACLE RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-4224
Practice Address - Country:US
Practice Address - Phone:520-219-5060
Practice Address - Fax:520-219-2993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty