Healthcare Provider Details

I. General information

NPI: 1962150888
Provider Name (Legal Business Name): HUNTER TEMPLE DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/10/2022
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

227 N MARKET ST
PAXTON IL
60957-1123
US

IV. Provider business mailing address

1120 N MELVIN ST
GIBSON CITY IL
60936-1477
US

V. Phone/Fax

Practice location:
  • Phone: 217-379-4864
  • Fax: 217-379-6494
Mailing address:
  • Phone: 217-784-4251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036181047
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOL61428982
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: