Healthcare Provider Details

I. General information

NPI: 1376460857
Provider Name (Legal Business Name): HUNTER HURLEY OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

741 E BROADWAY BLVD
JEFFERSON CITY TN
37760-4907
US

IV. Provider business mailing address

1213 MADISON OAKS RD
KNOXVILLE TN
37924-4581
US

V. Phone/Fax

Practice location:
  • Phone: 865-475-8680
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4017
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: