Provider Demographics
NPI:1265436539
Name:HUNT, GARY W (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:W
Last Name:HUNT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7100 COMMERCE WAY
Mailing Address - Street 2:SUITE 180
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-2829
Mailing Address - Country:US
Mailing Address - Phone:615-465-7000
Mailing Address - Fax:615-309-3338
Practice Address - Street 1:2855 OLD HIGHWAY 5
Practice Address - Street 2:STE 104
Practice Address - City:BLUE RIDGE
Practice Address - State:GA
Practice Address - Zip Code:30513-6239
Practice Address - Country:US
Practice Address - Phone:706-258-4868
Practice Address - Fax:706-258-1165
Is Sole Proprietor?:No
Enumeration Date:2005-06-02
Last Update Date:2009-09-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN23837207Q00000X
GA33359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3003042OtherTENNCARE SELECT
GA456399OtherWELLCARE
GA00486098DMedicaid
NC890640RMedicaid
TN3003042OtherBCBS
GAGA0101OtherAMERICHOICE EAST TENNCARE
GA071095OtherBCBS
TN3883955Medicaid
GA456399OtherWELLCARE
GAE99362Medicare UPIN
GA00486098DMedicaid
GAGA0101OtherAMERICHOICE EAST TENNCARE