Provider Demographics
NPI:1134339278
Name:STENZEL, HUNTER A (DO)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:A
Last Name:STENZEL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1080 NEAL ST STE 103
Mailing Address - Street 2:
Mailing Address - City:COOKEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38501-0943
Mailing Address - Country:US
Mailing Address - Phone:931-526-3316
Mailing Address - Fax:931-614-7517
Practice Address - Street 1:1080 NEAL ST STE 103
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501
Practice Address - Country:US
Practice Address - Phone:931-526-3316
Practice Address - Fax:931-614-7517
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2502207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100419730Medicaid
TNQ002232Medicaid
TN4355709OtherBCBS
OH4248171Medicare PIN
OH2551671OtherPARTNERS PHYSICIAN GROUP MEDICAID GROUP #
OH1083864144OtherPORTAGE HILLS TYPE 2 NPI #