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General NPI Number Information
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NPI Number | 1053592568
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Entity Type | Organization
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Legal Business Name | SURGERY CENTER ANESTHESIOLOGISTS, LLC
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Dates
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Enumeration Date | 11/27/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 13421 OLD MERIDIAN ST
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City | CARMEL
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State | IN
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Zip | 46032-1427
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Country | US
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Telephone | 317-706-1600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 68952
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City | INDIANAPOLIS
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State | IN
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Zip | 46268-0952
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Country | US
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Telephone | 317-802-6400
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Fax | 317-870-0499
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Authorized Official
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Title or Position | AUTHORIZED REP
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Name | MICHAEL N PAYNE
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Credential | MD
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Telephone | 317-235-8825
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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