Healthcare Provider Details

I. General information

NPI: 1619159647
Provider Name (Legal Business Name): CHRISTOPHER THOMAS HUNNICUTT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2007
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 DEBARR RD STE 360
ANCHORAGE AK
99508-6809
US

IV. Provider business mailing address

380 SUMMIT AVE., MSO PHYSICIAN BILLING
STEUBENVILLE OH
43952-2667
US

V. Phone/Fax

Practice location:
  • Phone: 907-792-7920
  • Fax:
Mailing address:
  • Phone: 740-283-7776
  • Fax: 740-283-7807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number234334
License Number StateAK
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number35.123266
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: