Ychiva Hunter
Individual provider Active NPI Phlebology Physician · Rex, GA
NPI 1679145437 · NPPES record last updated Jul 12, 2021
Key facts
- NPI
- 1679145437
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Phlebology Physician 202K00000X
- License
- 29668 (GA)
- Practice address
- 6690 Bent Creek Dr
Rex, GA 30273-2101 - Phone
- (678) 243-8342
- NPI assigned
- Jul 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29668 | GA | MD | Phlebology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebology Physician | 202K00000X | 29668 | GA | Yes |
Addresses
Primary practice location
6690 Bent Creek Dr
Rex, GA 30273-2101
Mailing address
PO Box 629
Rex, GA 30273-0629
Phone (470) 716-5994
Other providers in Rex, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.