Healthcare Provider Details
I. General information
NPI: 1346246071
Provider Name (Legal Business Name): LOREN W HUNT JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/27/2005
Last Update Date: 10/18/2023
Certification Date: 10/18/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
330 HAWTHORNE LN
ATHENS GA
30606-2152
US
IV. Provider business mailing address
PO BOX 603725
CHARLOTTE NC
28260-3725
US
V. Phone/Fax
- Phone: 706-613-8500
- Fax: 706-613-8844
- Phone: 828-575-2625
- Fax: 828-350-2174
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | 020549 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207K00000X |
| Taxonomy | Allergy & Immunology Physician |
| License Number | 20549 |
| License Number State | GA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: