=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063055465
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FIELD MEDICINE, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2019
-----------------------------------------------------
Last Update Date | 10/18/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 235 W JACKSON ST
-----------------------------------------------------
City | THOMASVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31792-5404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-870-9956
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 235 W JACKSON ST
-----------------------------------------------------
City | THOMASVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 31792-5404
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 352-870-9956
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. JAMES MONROE HUNT
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 352-870-9956
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RR0500X
-----------------------------------------------------
Taxonomy Name | Rheumatology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------