Healthcare Provider Details

I. General information

NPI: 1013978808
Provider Name (Legal Business Name): THOMAS E HUNT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7206 MARKET ST STE 100A
BOARDMAN OH
44512-4507
US

IV. Provider business mailing address

7206 MARKET ST STE 100A
BOARDMAN OH
44512-4507
US

V. Phone/Fax

Practice location:
  • Phone: 330-726-3379
  • Fax: 330-726-8683
Mailing address:
  • Phone: 330-726-3379
  • Fax: 330-726-8683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number34007472H
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: