Provider Demographics
NPI:1154734465
Name:THOMAS HUNTER & ASSOCIATES, PLLC
Entity type:Organization
Organization Name:THOMAS HUNTER & ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:L
Authorized Official - Last Name:KNOX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:304-343-4177
Mailing Address - Street 1:830 PENNSYLVANIA AVE
Mailing Address - Street 2:STE 402
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25302-3302
Mailing Address - Country:US
Mailing Address - Phone:304-343-4177
Mailing Address - Fax:304-343-0875
Practice Address - Street 1:830 PENNSYLVANIA AVE
Practice Address - Street 2:STE 402
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25302-3302
Practice Address - Country:US
Practice Address - Phone:304-343-4177
Practice Address - Fax:304-343-0875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-04
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV12093207V00000X
WV19845207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0094534000Medicaid
WV6200040000Medicaid
WVA72113Medicare UPIN
WV0094534000Medicaid