Provider Demographics
NPI:1043257363
Name:HUNT, JAMES MONROE (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:MONROE
Last Name:HUNT
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DONIPHAN
Mailing Address - State:MO
Mailing Address - Zip Code:63935-1763
Mailing Address - Country:US
Mailing Address - Phone:573-996-3934
Mailing Address - Fax:573-996-3937
Practice Address - Street 1:204 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:DONIPHAN
Practice Address - State:MO
Practice Address - Zip Code:63935-1763
Practice Address - Country:US
Practice Address - Phone:573-996-3937
Practice Address - Fax:573-996-3937
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000145927152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO314833906Medicaid
MOU78591Medicare UPIN
MO314833906Medicaid
MO000091156Medicare PIN