Provider Demographics
NPI:1790375830
Name:HUNT, THOMAS DEWAYNE (DPH)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:DEWAYNE
Last Name:HUNT
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 933
Mailing Address - Street 2:
Mailing Address - City:NORRIS
Mailing Address - State:TN
Mailing Address - Zip Code:37828-0933
Mailing Address - Country:US
Mailing Address - Phone:865-494-8844
Mailing Address - Fax:865-494-8444
Practice Address - Street 1:3318 ANDERSONVILLE HWY
Practice Address - Street 2:
Practice Address - City:ANDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37705-3816
Practice Address - Country:US
Practice Address - Phone:865-494-8444
Practice Address - Fax:865-494-8402
Is Sole Proprietor?:No
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist