Provider Demographics
NPI:1699784538
Name:HUNT, CHARLES AUSTIN II (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:AUSTIN
Last Name:HUNT
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4721 CHACE CIR
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-3700
Mailing Address - Country:US
Mailing Address - Phone:205-823-0151
Mailing Address - Fax:205-823-5218
Practice Address - Street 1:4721 CHACE CIR
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-3700
Practice Address - Country:US
Practice Address - Phone:205-823-0151
Practice Address - Fax:205-823-5218
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD39919208G00000X
AL28894208G00000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051120874OtherBCBS
AL51040048OtherBCBS
ALH99246OtherVIVA
AL051120873OtherBCBS
AL051120872OtherBCBS
AL132504Medicaid
AL051120873OtherBCBS
MS02827391Medicaid
AL051120872OtherBCBS
ALH99246OtherVIVA
AL132500Medicaid
AL102I336814Medicare PIN