Provider Demographics
NPI:1386965739
Name:HURT, ROBERT NEAL
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NEAL
Last Name:HURT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 RIDGEWAY DR
Mailing Address - Street 2:
Mailing Address - City:BELDEN
Mailing Address - State:MS
Mailing Address - Zip Code:38826-9758
Mailing Address - Country:US
Mailing Address - Phone:662-841-7776
Mailing Address - Fax:
Practice Address - Street 1:4213 RIDGEWAY DR
Practice Address - Street 2:
Practice Address - City:BELDEN
Practice Address - State:MS
Practice Address - Zip Code:38826-9758
Practice Address - Country:US
Practice Address - Phone:662-841-7776
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSMISSISSIPPI03333207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine