MEDICARE: DR. JEFFERSON T HUNT D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	65262	GA
2	390200000X	Student in an Organized Health Care Education/Training Program	65262	GA
3	207N00000X	Dermatology Physician	65262	GA

General Provider Information

NPI Number	:	1083843221
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFERSON T HUNT D.O.

Provider Business Mailing Address
First Line	:	6600 VAN AALST BLVD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31905-2102
Country	:	US
Telephone Number	:	762-408-3305
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 VAN AALST BLVD
Second Line	:
City	:	COLUMBUS
State	:	GA
Zip	:	31905-2102
Country	:	US
Telephone Number	:	762-408-3305
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/09/2009
Last Update Date	:	07/21/2022

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