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General NPI Number Information
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NPI Number | 1760965206
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Entity Type | Organization
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Legal Business Name | HUNTER ASSETS HOLDING LLC
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Dates
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Enumeration Date | 09/11/2018
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Last Update Date | 09/25/2018
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Provider Practice Location Address
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Address Line | 1035 W MAYES ST
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City | JACKSON
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State | MS
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Zip | 39213-6100
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Country | US
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Telephone | 601-427-7101
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Fax |
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Provider Business Mailing Address
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Address Line | 350 W WOODROW WILSON AVE STE 311
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City | JACKSON
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State | MS
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Zip | 39213-7681
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Country | US
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Telephone | 601-427-7101
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Fax | 601-427-7103
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Authorized Official
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Title or Position | MEDICAL COORDINATOR
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Name | DR. FRENCHIE COTTON RUSSELL
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Credential | RPH
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Telephone | 601-427-7101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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