Basic Information
| Provider Information | |||||||||
| NPI: | 1811976616 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUNTER | ||||||||
| FirstName: | BRIAN | ||||||||
| MiddleName: | L. | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24 LEFT PENHOOK RD | ||||||||
| Address2: | |||||||||
| City: | HAROLD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 416357064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064788787 | ||||||||
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| Practice Location | |||||||||
| Address1: | 24 LEFT PEN HOOK | ||||||||
| Address2: | |||||||||
| City: | HAROLD | ||||||||
| State: | KY | ||||||||
| PostalCode: | 416359033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064788787 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/11/2006 | ||||||||
| LastUpdateDate: | 09/30/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | TC517 | KY | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363A00000X | PA809 | KY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
No ID Information.