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General NPI Number Information
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NPI Number | 1003043423
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Entity Type | Individual
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Provider Name | JAMES DANIEL STOUGH DPM
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Gender | Male
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Dates
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Enumeration Date | 06/11/2009
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Last Update Date | 08/19/2019
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Provider Practice Location Address
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Address Line | 314 E OWEN K GARRIOTT RD
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City | ENID
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State | OK
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Zip | 73701-5712
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Country | US
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Telephone | 580-249-3929
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Fax | 580-234-3301
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Provider Business Mailing Address
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Address Line | PO BOX 3046
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City | MALVERN
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State | PA
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Zip | 19355-0746
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Country | US
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Telephone | 580-249-3929
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 298
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License Number State | OK
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