Provider Demographics
NPI:1619404936
Name:NOLEN, HUNTER P (MD)
Entity Type:Individual
Prefix:
First Name:HUNTER
Middle Name:P
Last Name:NOLEN
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 1:800 STANTON L YOUNG BLVD STE 9000
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5018
Mailing Address - Country:US
Mailing Address - Phone:405-271-6308
Mailing Address - Fax:
Practice Address - Street 1:3920 S DUPONT SQ STE C
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4615
Practice Address - Country:US
Practice Address - Phone:812-282-3899
Practice Address - Fax:812-282-4172
Is Sole Proprietor?:No
Enumeration Date:2017-05-17
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK32964208600000X
KY56838208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN412840157OtherMEDICARE
KY7100825420Medicaid
IN300063666Medicaid