Provider Demographics
NPI:1932431053
Name:HUNSAKER, COLLEEN R (DO)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:R
Last Name:HUNSAKER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:COLLEEN
Other - Middle Name:C
Other - Last Name:RISSELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:14300 N NORTHSIGHT BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-3674
Mailing Address - Country:US
Mailing Address - Phone:480-483-8986
Mailing Address - Fax:480-219-3997
Practice Address - Street 1:14300 N NORTHSIGHT BLVD STE 114
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-3674
Practice Address - Country:US
Practice Address - Phone:480-483-8986
Practice Address - Fax:480-219-3997
Is Sole Proprietor?:No
Enumeration Date:2010-02-01
Last Update Date:2012-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2843207QA0505X, 2083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine