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General NPI Number Information
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NPI Number | 1023127966
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Entity Type | Individual
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Provider Name | RONALD ALLEN DAVIS CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 180 DEBUYS RD.
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City | BILOXI
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State | MS
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Zip | 39531
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Country | US
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Telephone | 228-860-0157
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Fax | 228-860-0157
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Provider Business Mailing Address
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Address Line | 12608 OAK FOREST DR
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City | GULFPORT
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State | MS
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Zip | 39503-5732
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Country | US
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Telephone | 228-832-3516
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Fax | 228-832-3516
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1-053282
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | R662275
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License Number State | MS
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