Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 8031888-8903 | UT |
Y | 213EG0000X | General Practice | 8031888-8903 | UT |
NPI | 1003194168 |
---|---|
Provider Name | Adam R Hurst |
First Address | Apo, AP 96367 |
Second Address | Apo, AP 96368-5142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2011 |
Last Update Date | 19/08/2013 |