Healthcare Provider Details

I. General information

NPI: 1669386751
Provider Name (Legal Business Name): MR. MELVIN EXCELL HUNTER SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 HOOVER DR
SLIDELL LA
70461-2214
US

IV. Provider business mailing address

202 HOOVER DR
SLIDELL LA
70461-2214
US

V. Phone/Fax

Practice location:
  • Phone: 504-266-5997
  • Fax:
Mailing address:
  • Phone: 504-266-5997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number19924
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: