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General NPI Number Information
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NPI Number | 1033919790
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Entity Type | Organization
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Legal Business Name | RESURGENS, LLC
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 03/13/2025
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Provider Practice Location Address
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Address Line | 1223 FRIENDSHIP RD STE 220
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City | BRASELTON
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State | GA
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Zip | 30517-5608
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Country | US
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Telephone | 470-762-3641
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Fax | 470-762-3643
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Provider Business Mailing Address
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Address Line | PO BOX 21068
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City | BELFAST
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State | ME
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Zip | 04915-4107
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Country | US
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Telephone | 404-847-9999
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | VALERIE R SPRINGER
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Credential |
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Telephone | 404-531-8615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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