Provider Demographics
NPI:1063441699
Name:PONDEXTER HUNTER, REGINA KAY (MD)
Entity type:Individual
Prefix:DR
First Name:REGINA
Middle Name:KAY
Last Name:PONDEXTER HUNTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:REGINA
Other - Middle Name:PONDEXTER
Other - Last Name:PONDEXTER HUNTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:500 S UNIVERSITY AVE STE 318
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-5305
Mailing Address - Country:US
Mailing Address - Phone:501-225-6900
Mailing Address - Fax:501-225-6911
Practice Address - Street 1:500 S UNIVERSITY AVE STE 318
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5305
Practice Address - Country:US
Practice Address - Phone:501-225-6900
Practice Address - Fax:501-225-6911
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE4522208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5G534OtherMEDICARE ID
AR7145960001Medicare NSC
AR5G534OtherMEDICARE ID
ARI44789Medicare UPIN