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1043439854 NPI number — RODNEY WILLIAM BAINE MD,MFA,PHD

NPI Number: 1043439854
Health Care Provider/Practitioner: RODNEY WILLIAM BAINE MD,MFA,PHD

Information about “1043439854” NPI (RODNEY WILLIAM BAINE MD,MFA,PHD) exists in 1043439854 in HTML format HTML  |  1043439854 in plain Text format TXT  |  1043439854 in PDF (Portable Document Format) PDF  |  1043439854 in an XML format XML  formats.

NPI Number : 1043439854 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1043439854",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BAINE",
    "FirstName": "RODNEY",
    "MiddleName": "WILLIAM",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD,MFA,PHD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "125 RIDGE RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CLARKSDALE",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "38614-9765",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "662-627-5151",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1970 HOSPITAL DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CLARKSDALE",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "38614-7202",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "662-624-3580",
    "PracticeLocationAddressFaxNumber": "662-624-6673",
    "EnumerationDate": "04/24/2007",
    "LastUpdateDate": "07/08/2007",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207P00000X",
        "TaxonomyName": "Emergency Medicine Physician",
        "LicenseNumber": "07201",
        "LicenseNumberStateCode": "MS",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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