Healthcare Provider Details

I. General information

NPI: 1114759230
Provider Name (Legal Business Name): MADISON ABIGAIL HUNT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/16/2024
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 N DECATUR RD STE 520
DECATUR GA
30033-5918
US

IV. Provider business mailing address

3725 BIG SPRINGS RD
DECATUR GA
30034-4952
US

V. Phone/Fax

Practice location:
  • Phone: 404-501-2560
  • Fax:
Mailing address:
  • Phone: 253-929-9536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number13873
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: