MEDICARE: HUNT AND MITCHELL, M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	ME34625	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	74997	OTHER	FL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1669535589
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUNT AND MITCHELL, M.D., P.A.

Provider Business Mailing Address
First Line	:	2624 JENKS AVE STE B
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4311
Country	:	US
Telephone Number	:	850-763-5413
Fax Number	:	850-769-6222

Provider Business Practice Location Address
First Line	:	2624 JENKS AVE STE B
Second Line	:
City	:	PANAMA CITY
State	:	FL
Zip	:	32405-4311
Country	:	US
Telephone Number	:	850-763-5413
Fax Number	:	850-769-6222

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAUL J HUNT JR.
Credential	:	M.D.
Telephone Number	:	850-763-5413

Provider Enumeration Date	:	12/19/2006
Last Update Date	:	08/22/2020

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