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General NPI Number Information
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NPI Number | 1053487124
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Entity Type | Individual
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Provider Name | JAMES L HEALY O.D.
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Gender | Male
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 01/30/2020
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Provider Practice Location Address
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Address Line | 1113 17TH AVE
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City | MONROE
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State | WI
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Zip | 53566-2063
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Country | US
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Telephone | 608-325-5606
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Fax | 608-325-5637
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Provider Business Mailing Address
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Address Line | 1113 17TH AVE P.O. BOX 299
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City | MONROE
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State | WI
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Zip | 53566-2063
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Country | US
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Telephone | 608-325-5606
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Fax | 608-325-5637
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 1670
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License Number State | WI
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