Healthcare Provider Details

I. General information

NPI: 1003830993
Provider Name (Legal Business Name): KATHLEEN S HUNT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 BLACKFORD ST
CHATTANOOGA TN
37403-1405
US

IV. Provider business mailing address

PO BOX 11503
CHATTANOOGA TN
37401-2503
US

V. Phone/Fax

Practice location:
  • Phone: 423-778-6505
  • Fax: 423-778-3157
Mailing address:
  • Phone: 423-778-3274
  • Fax: 423-778-2255

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number37961
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: