Provider Demographics
NPI:1528539103
Name:HURT, ANTHONY GENE (PHARMD, MLS(ASCP))
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:GENE
Last Name:HURT
Suffix:
Gender:M
Credentials:PHARMD, MLS(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 TOWN AND COUNTRY LN STE 101
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9524
Mailing Address - Country:US
Mailing Address - Phone:606-435-0460
Mailing Address - Fax:606-435-0461
Practice Address - Street 1:101 TOWN AND COUNTRY LN STE 101
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9524
Practice Address - Country:US
Practice Address - Phone:606-435-0460
Practice Address - Fax:606-435-0461
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-07
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY235118246QM0706X
KY013617183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist