MEDICARE: BK HUNT MANAGEMENT INC

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	208VP0014X	Interventional Pain Medicine Physician

General Provider Information

NPI Number	:	1487408241
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BK HUNT MANAGEMENT INC

Provider Business Mailing Address
First Line	:	PO BOX 34120
Second Line	:
City	:	RENO
State	:	NV
Zip	:	89533-4120
Country	:	US
Telephone Number	:	775-747-5050
Fax Number	:	775-747-5005

Provider Business Practice Location Address
First Line	:	8135 SARATOGA WAY
Second Line	:
City	:	EL DORADO HILLS
State	:	CA
Zip	:	95762-4590
Country	:	US
Telephone Number	:	916-232-8775
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BRIAN KELLY
Credential	:	MD
Telephone Number	:	775-747-5050

Provider Enumeration Date	:	04/16/2024
Last Update Date	:	06/11/2024

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