Provider Demographics
NPI:1750751640
Name:DELAWARE PRIMARY PHYSICIANS
Entity type:Organization
Organization Name:DELAWARE PRIMARY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:K
Authorized Official - Last Name:HUNT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-275-5089
Mailing Address - Street 1:2500 WRANGLE HILL RD STE 205
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-3838
Mailing Address - Country:US
Mailing Address - Phone:302-838-3100
Mailing Address - Fax:302-838-3140
Practice Address - Street 1:2500 WRANGLE HILL RD STE 205
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-3838
Practice Address - Country:US
Practice Address - Phone:302-838-3100
Practice Address - Fax:302-838-3140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10011234207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty