MEDICARE: SCOTT D HUNT PAC

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	363AM0700X	Medical Physician Assistant	PA03736	TX

General Provider Information

NPI Number	:	1396767745
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT D HUNT PAC

Provider Business Mailing Address
First Line	:	2901 INDIANA BLVD
Second Line	:	106
City	:	DALLAS
State	:	TX
Zip	:	75226-1520
Country	:	US
Telephone Number	:	865-816-9963
Fax Number	:

Provider Business Practice Location Address
First Line	:	4021 S 700 E STE 300
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84107-2184
Country	:	US
Telephone Number	:	800-634-9583
Fax Number	:

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	08/29/2015

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