1265484836 NPI number — WILLIAM P HUNT MD

Table of content: WILLIAM P HUNT MD (NPI 1265484836)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265484836 NPI number — WILLIAM P HUNT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNT
Provider First Name:
WILLIAM
Provider Middle Name:
P
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1265484836
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/09/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
200 MILL ROAD, SUITE 180
Provider Second Line Business Mailing Address:
SOUTHCOAST PHYSICIAN SERVICES, INC.
Provider Business Mailing Address City Name:
FAIRHAVEN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02719-5252
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-973-2000
Provider Business Mailing Address Fax Number:
508-973-2001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
543 NORTH STREET
Provider Second Line Business Practice Location Address:
SOUTHCOAST PHYSICIAN SERVICES, INC.
Provider Business Practice Location Address City Name:
NEW BEDFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02740-2766
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-996-1800
Provider Business Practice Location Address Fax Number:
508-992-7906
Provider Enumeration Date:
05/16/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  057167 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 57167 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2042568 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".