Healthcare Provider Details

I. General information

NPI: 1326089426
Provider Name (Legal Business Name): JOSEPH STEVE HURST M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2006
Last Update Date: 05/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 NORTH AVE SUITE B
COLUMBUS GA
31904
US

IV. Provider business mailing address

P.O. BOX 4239
COLUMBUS GA
31914-0239
US

V. Phone/Fax

Practice location:
  • Phone: 706-507-5911
  • Fax: 706-507-5913
Mailing address:
  • Phone: 706-507-5911
  • Fax: 706-507-5913

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number040416
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: