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General NPI Number Information
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NPI Number | 1053455360
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Entity Type | Individual
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Provider Name | HEATHER MCREE REYNOLDS PHARM D
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Gender | Female
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Dates
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Enumeration Date | 02/19/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 114 HANCOCK ST S
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City | FORT GAINES
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State | GA
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Zip | 39851-4338
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Country | US
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Telephone | 229-768-2422
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Fax | 229-768-2449
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Provider Business Mailing Address
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Address Line | 423 WOODLAWN DR
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City | EUFAULA
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State | AL
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Zip | 36027-5024
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Country | US
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Telephone | 334-688-5095
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 022488
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License Number State | GA
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