Basic Information
| Provider Information | |||||||||
| NPI: | 1417941022 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUNT | ||||||||
| FirstName: | JOE | ||||||||
| MiddleName: | W | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 202 TUCKER AVE | ||||||||
| Address2: | |||||||||
| City: | RIPLEY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 380631631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7312874500 | ||||||||
| FaxNumber: | 7312874804 | ||||||||
| Practice Location | |||||||||
| Address1: | 202 TUCKER AVE | ||||||||
| Address2: | |||||||||
| City: | RIPLEY | ||||||||
| State: | TN | ||||||||
| PostalCode: | 380631631 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7316354741 | ||||||||
| FaxNumber: | 7316353466 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/09/2005 | ||||||||
| LastUpdateDate: | 09/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 09/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD0000013611 | TN | N | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD013611 | TN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 080056360 | 01 | PALMETTO GBA | OTHER | 7151 | 01 | TLC (MEMPHIS MAN. CARE) | OTHER | 4025313 | 01 | AETNA | OTHER | 0198620 | 01 | BLUE CROSS | OTHER | 0140415 | 01 | UNITED HEALTHCARE | OTHER | 116252 | 01 | BETTER HEALTH PLAN | OTHER | 7781038 | 01 | CIGNA | OTHER | 3001790 | 05 | TN | MEDICAID | 0198620 | 01 | TN | BLUE CROSS | OTHER |