Healthcare Provider Details

I. General information

NPI: 1275530297
Provider Name (Legal Business Name): JOHN HUNTS MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 12/17/2013
Certification Date:
Deactivation Date: 03/20/2006
Reactivation Date: 04/05/2006

III. Provider practice location address

2550 WILLAKENZIE RD
EUGENE OR
97401-7865
US

IV. Provider business mailing address

2550 WILLAKENZIE RD
EUGENE OR
97401-7865
US

V. Phone/Fax

Practice location:
  • Phone: 541-434-0922
  • Fax: 541-434-4369
Mailing address:
  • Phone: 541-434-0922
  • Fax: 541-434-4369

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD19148
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: