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General NPI Number Information
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NPI Number | 1023126729
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Entity Type | Individual
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Provider Name | BENNIE W CHILES III MD
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Gender | Male
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 280 N CENTRAL AVE SUITE 235
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City | HARTSDALE
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State | NY
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Zip | 10530-1832
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Country | US
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Telephone | 914-332-0396
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Fax | 914-468-8895
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Provider Business Mailing Address
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Address Line | PO BOX 957
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City | HARTSDALE
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State | NY
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Zip | 10530-0957
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Country | US
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Telephone | 914-332-0396
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Fax | 914-468-8895
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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 | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 193451
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License Number State | NY
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