Healthcare Provider Details

I. General information

NPI: 1043279029
Provider Name (Legal Business Name): JAMES LEWIS HUNT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2006
Last Update Date: 11/27/2023
Certification Date: 10/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1820 SHAFFER ST
KALAMAZOO MI
49048-1656
US

IV. Provider business mailing address

1820 SHAFFER ST
KALAMAZOO MI
49048-1656
US

V. Phone/Fax

Practice location:
  • Phone: 269-381-7136
  • Fax: 269-381-6665
Mailing address:
  • Phone: 269-381-7136
  • Fax: 269-381-6665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301055736
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: