Provider Demographics
NPI:1710116595
Name:HUNT, PATRICK JOSEPH (IDMT)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:JOSEPH
Last Name:HUNT
Suffix:
Gender:M
Credentials:IDMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:383 MAYNARD ST
Mailing Address - Street 2:
Mailing Address - City:POPE AFB
Mailing Address - State:NC
Mailing Address - Zip Code:28308-2321
Mailing Address - Country:US
Mailing Address - Phone:910-394-2232
Mailing Address - Fax:
Practice Address - Street 1:1 MATERO DR
Practice Address - Street 2:OL-C 342TRS
Practice Address - City:POPE
Practice Address - State:NC
Practice Address - Zip Code:28308
Practice Address - Country:US
Practice Address - Phone:910-394-2232
Practice Address - Fax:910-394-2873
Is Sole Proprietor?:No
Enumeration Date:2009-07-14
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1003XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Medical Technicians