Provider Demographics
NPI:1861437311
Name:JOHN D HUNTER
Entity type:Organization
Organization Name:JOHN D HUNTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-373-5950
Mailing Address - Street 1:1751 GARDNER WAY
Mailing Address - Street 2:STE D
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-6513
Mailing Address - Country:US
Mailing Address - Phone:907-373-5950
Mailing Address - Fax:907-373-5954
Practice Address - Street 1:1751 GARDNER WAY
Practice Address - Street 2:STE D
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-6513
Practice Address - Country:US
Practice Address - Phone:907-373-5950
Practice Address - Fax:907-373-5954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK2921207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKD96315Medicare UPIN
AKK0000BKFQKMedicare PIN