Healthcare Provider Details

I. General information

NPI: 1134339278
Provider Name (Legal Business Name): HUNTER A STENZEL D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 09/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 NEAL ST STE 103
COOKEVILLE TN
38501
US

IV. Provider business mailing address

1080 NEAL ST STE 103
COOKEVILLE TN
38501-0943
US

V. Phone/Fax

Practice location:
  • Phone: 931-526-3316
  • Fax: 931-614-7517
Mailing address:
  • Phone: 931-526-3316
  • Fax: 931-614-7517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2502
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: