Provider Demographics
NPI:1811998651
Name:HURT, JOEL H (MD)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:H
Last Name:HURT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11675 JOLLYVILLE RD
Mailing Address - Street 2:STE 207
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-4105
Mailing Address - Country:US
Mailing Address - Phone:512-856-1000
Mailing Address - Fax:512-856-4040
Practice Address - Street 1:11675 JOLLYVILLE RD
Practice Address - Street 2:STE 207
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-4105
Practice Address - Country:US
Practice Address - Phone:512-856-1000
Practice Address - Fax:512-856-4040
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8378207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00477947OtherMEDICARE RAILROAD
TXL8378OtherSTATE BOARD LICENSE
TX00G83LOtherGROUP MEDICARE NUMBER
TX8D5465Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE
TX00G83LOtherGROUP MEDICARE NUMBER
TX8K3125Medicare PIN
TXL8378OtherSTATE BOARD LICENSE
TX8L22885Medicare PIN