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General NPI Number Information
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NPI Number | 1043459613
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Entity Type | Individual
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Provider Name | LASHONDA KENYA BLOODSAW-SCOTT P.A.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2009
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 1735 N BROWN RAOD HEALTH CARE PARTNERS
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-3872
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Country | US
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Telephone | 352-383-4505
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Fax | 678-218-4041
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Provider Business Mailing Address
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Address Line | 1735 N BROWN RD
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-8158
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Country | US
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Telephone | 352-383-4505
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Fax | 678-218-4041
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 5340
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License Number State | GA
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