Provider Demographics
NPI:1700030830
Name:HUNT SPINAL CARE PLLC
Entity Type:Organization
Organization Name:HUNT SPINAL CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-459-0333
Mailing Address - Street 1:7614 E 91ST ST STE 160
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-6047
Mailing Address - Country:US
Mailing Address - Phone:918-459-0333
Mailing Address - Fax:918-459-8880
Practice Address - Street 1:7614 E 91ST ST STE 160
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6047
Practice Address - Country:US
Practice Address - Phone:918-459-0333
Practice Address - Fax:918-459-8880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK383725303001OtherBLUE CROSS BLUE SHIELD
OKOKB5619Medicare PIN