Provider Demographics
NPI:1346603784
Name:HUNTER, WYNN G (MD, MHSC)
Entity type:Individual
Prefix:
First Name:WYNN
Middle Name:G
Last Name:HUNTER
Suffix:
Gender:M
Credentials:MD, MHSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 S 59TH STREET CT
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68506-5106
Mailing Address - Country:US
Mailing Address - Phone:513-255-3249
Mailing Address - Fax:
Practice Address - Street 1:7500 S 91ST ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68526-9437
Practice Address - Country:US
Practice Address - Phone:402-489-6555
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-02
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS7679207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty