Provider Demographics
NPI:1740461938
Name:HUNT, WINSTON HUGH (PA)
Entity type:Individual
Prefix:
First Name:WINSTON
Middle Name:HUGH
Last Name:HUNT
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2749 DEER TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:THOMSON
Mailing Address - State:GA
Mailing Address - Zip Code:30824-6515
Mailing Address - Country:US
Mailing Address - Phone:706-595-2728
Mailing Address - Fax:
Practice Address - Street 1:2749 DEER TRAIL RD
Practice Address - Street 2:
Practice Address - City:THOMSON
Practice Address - State:GA
Practice Address - Zip Code:30824-6515
Practice Address - Country:US
Practice Address - Phone:706-595-2728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA000072363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical