Healthcare Provider Details

I. General information

NPI: 1215009980
Provider Name (Legal Business Name): RODNEY ARNELL HUNT D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

971 LAKELAND DR STE 600
JACKSON MS
39216-4608
US

IV. Provider business mailing address

971 LAKELAND DR STE 600
JACKSON MS
39216-4608
US

V. Phone/Fax

Practice location:
  • Phone: 601-981-3111
  • Fax:
Mailing address:
  • Phone: 601-981-3111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number1521-72
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: