Provider Demographics
NPI:1396767745
Name:HUNT, SCOTT D (PAC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:HUNT
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2901 INDIANA BLVD
Mailing Address - Street 2:106
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75226-1520
Mailing Address - Country:US
Mailing Address - Phone:865-816-9963
Mailing Address - Fax:
Practice Address - Street 1:4021 S 700 E STE 300
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2184
Practice Address - Country:US
Practice Address - Phone:800-634-9583
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2015-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA03736363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS06794Medicare UPIN