Provider Demographics
NPI:1255567459
Name:HUNT, EDWARD (DC)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:
Last Name:HUNT
Suffix:
Gender:M
Credentials:DC
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 14126
Mailing Address - Street 2:SUITE 207 F
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39236-4126
Mailing Address - Country:US
Mailing Address - Phone:601-991-3156
Mailing Address - Fax:601-991-3157
Practice Address - Street 1:405 BRIARWOOD DR
Practice Address - Street 2:SUITE 207 F
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39206-3052
Practice Address - Country:US
Practice Address - Phone:601-991-3156
Practice Address - Fax:601-991-3157
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS0873111N00000X, 111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation