Provider Demographics
NPI:1366688780
Name:HUNTER, JAMES HENRY JR (MED)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:HENRY
Last Name:HUNTER
Suffix:JR
Gender:M
Credentials:MED
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 M
Mailing Address - Street 2:
Mailing Address - City:GARYSBURG
Mailing Address - State:NC
Mailing Address - Zip Code:27831-0330
Mailing Address - Country:US
Mailing Address - Phone:252-537-4005
Mailing Address - Fax:
Practice Address - Street 1:608 JACKSON ST STE B
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-2656
Practice Address - Country:US
Practice Address - Phone:252-537-4005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-07
Last Update Date:2009-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7233101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC142000504Medicaid