Provider Demographics
NPI:1295776516
Name:HUNTON, REBECCA PRICE (MD)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:PRICE
Last Name:HUNTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 5TH AVE APT 101
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-4224
Mailing Address - Country:US
Mailing Address - Phone:321-254-6803
Mailing Address - Fax:321-254-6819
Practice Address - Street 1:417 5TH AVE APT 101
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903-4224
Practice Address - Country:US
Practice Address - Phone:321-254-6803
Practice Address - Fax:321-254-6819
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-09
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35081962207Q00000X
FLME95892207QA0505X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2430980Medicaid
OH2430980Medicaid