Provider Demographics
NPI:1962545517
Name:HUNT, WILLIAM K (PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:K
Last Name:HUNT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2957
Mailing Address - Street 2:445 CAMINO DEL REY, SUITE B
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-2957
Mailing Address - Country:US
Mailing Address - Phone:505-222-0831
Mailing Address - Fax:505-222-0873
Practice Address - Street 1:445 CAMINO DEL REY
Practice Address - Street 2:SUITE B
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-8648
Practice Address - Country:US
Practice Address - Phone:505-222-0831
Practice Address - Fax:505-222-0873
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1051103TP0016X, 103TF0200X, 103G00000X
CA15463103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist