Provider Demographics
NPI:1902989007
Name:HUNT, ELBERT ANTHONY (MD)
Entity Type:Individual
Prefix:
First Name:ELBERT
Middle Name:ANTHONY
Last Name:HUNT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 334
Mailing Address - Street 2:
Mailing Address - City:BYHALIA
Mailing Address - State:MS
Mailing Address - Zip Code:38611
Mailing Address - Country:US
Mailing Address - Phone:662-838-5565
Mailing Address - Fax:662-838-4770
Practice Address - Street 1:2422 CHURCH ST
Practice Address - Street 2:
Practice Address - City:BYHALIA
Practice Address - State:MS
Practice Address - Zip Code:38611
Practice Address - Country:US
Practice Address - Phone:662-838-5565
Practice Address - Fax:662-838-4770
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS14652208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04383371Medicaid
MS04383371Medicaid