Basic Information
| Provider Information | |||||||||
| NPI: | 1972952703 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUNTER | ||||||||
| FirstName: | BENJAMIN | ||||||||
| MiddleName: | NEIL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 19662 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | IL | ||||||||
| PostalCode: | 627949662 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2175458000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3307 RENNER DR | ||||||||
| Address2: | |||||||||
| City: | FORTUNA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955403119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7077259383 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/13/2016 | ||||||||
| LastUpdateDate: | 09/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 125.069190 | IL | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | A180526 | CA | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.