Healthcare Provider Details

I. General information

NPI: 1992449722
Provider Name (Legal Business Name): JOSEPH GLENN HUNSAKER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2022
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 E CLARK BASS BLVD
MCALESTER OK
74501-4209
US

IV. Provider business mailing address

1 E CLARK BASS BLVD
MCALESTER OK
74501-4209
US

V. Phone/Fax

Practice location:
  • Phone: 918-421-4689
  • Fax:
Mailing address:
  • Phone: 918-421-4689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number8125
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number8125
License Number StateOK
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number8125
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: