Provider Demographics
NPI:1669622791
Name:HUNT REYES, CAMERON J (PA)
Entity type:Individual
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First Name:CAMERON
Middle Name:J
Last Name:HUNT REYES
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Gender:F
Credentials:PA
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Mailing Address - Street 1:12639 OLD TESSON RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2786
Mailing Address - Country:US
Mailing Address - Phone:314-849-0311
Mailing Address - Fax:314-849-4423
Practice Address - Street 1:10701 NALL AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1363
Practice Address - Country:US
Practice Address - Phone:913-631-3114
Practice Address - Fax:913-631-5263
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2015-02-16
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Provider Licenses
StateLicense IDTaxonomies
MO2008029331363A00000X
KST-02388363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant