Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 01050896A | IN |
NPI | 1124034038 |
---|---|
Provider Name | Dr. Jeremy J. Hunt |
First Address | Muncie, IN 47308-1643 |
Second Address | Muncie, IN 47304-5407 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 22/01/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000185911 | ANTHEM PIN (01) | IN |
200246060 | (05) | IN |
80167147 | RAILROAD MEDICARE (01) | IN |
H02190 | (02) | IN |