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General NPI Number Information
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NPI Number | 1023226438
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Entity Type | Organization
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Legal Business Name | MEDICAL EDUCATION ASSISTANCE CORPORATION
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Dates
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Enumeration Date | 05/18/2007
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Last Update Date | 04/25/2016
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Provider Practice Location Address
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Address Line | 2109 W MARKET ST ROOM 143
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6024
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Country | US
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Telephone | 423-439-8830
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Fax | 423-439-8580
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Provider Business Mailing Address
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Address Line | PO BOX 699
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City | MOUNTAIN HOME
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State | TN
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Zip | 37684-0699
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Country | US
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Telephone | 423-433-6039
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Fax | 423-433-6060
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | RUSSELL E LEWIS
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Credential |
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Telephone | 423-433-6050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0208X
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Taxonomy Name | Mobile Radiology Clinic/Center
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License Number |
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License Number State |
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