Healthcare Provider Details

I. General information

NPI: 1417151820
Provider Name (Legal Business Name): WILLIAM R. HUNT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2007
Last Update Date: 12/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1365 CLIFTON RD NE BUILDING A - ROOM 3244
ATLANTA GA
30322-1013
US

IV. Provider business mailing address

550 PEACHTREE ST NE TEC MEDICAL OFFICE TOWER
ATLANTA GA
30308-2212
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-7965
  • Fax: 404-778-3583
Mailing address:
  • Phone: 404-686-2505
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number064829
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number064829
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number064829
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number064829
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: