Provider Demographics
NPI:1366705360
Name:HUNT, SHEENA H (OD)
Entity type:Individual
Prefix:DR
First Name:SHEENA
Middle Name:H
Last Name:HUNT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1506 HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-3355
Mailing Address - Country:US
Mailing Address - Phone:304-636-2020
Mailing Address - Fax:304-636-5911
Practice Address - Street 1:1506 HARRISON AVE
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3355
Practice Address - Country:US
Practice Address - Phone:304-636-2020
Practice Address - Fax:304-636-5911
Is Sole Proprietor?:No
Enumeration Date:2012-06-25
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-C82152W00000X
WV1099-IOD152W00000X
VA0618002232152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1013192814OtherDMERC
WV1689853178Medicaid