Provider Demographics
NPI:1780676338
Name:HUNT, TRAVIS L (MD)
Entity Type:Individual
Prefix:
First Name:TRAVIS
Middle Name:L
Last Name:HUNT
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 1:1304 MONTELLO AVE
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1544
Mailing Address - Country:US
Mailing Address - Phone:541-386-3711
Mailing Address - Fax:541-386-6224
Practice Address - Street 1:1304 MONTELLO AVE
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1544
Practice Address - Country:US
Practice Address - Phone:541-386-3711
Practice Address - Fax:541-386-6224
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD21817174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR134237Medicaid
OR134237Medicaid
OR104476Medicare ID - Type Unspecified