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General NPI Number Information
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NPI Number | 1073686143
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Entity Type | Organization
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Legal Business Name | JAMES R ANGEL MD PLLC
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 04/21/2009
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Provider Practice Location Address
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Address Line | 1698 OLD LEBANON RD SUITE 3B
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-9662
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Country | US
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Telephone | 270-789-2471
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Fax | 270-465-4669
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Provider Business Mailing Address
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Address Line | 1698 OLD LEBANON RD SUITE 3B
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City | CAMPBELLSVILLE
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State | KY
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Zip | 42718-9662
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Country | US
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Telephone | 270-789-2471
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Fax | 270-465-4669
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Authorized Official
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Title or Position | OWNER
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Name | MR. JAMES RAYMOND ANGEL
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Credential | MD
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Telephone | 270-789-2471
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 20672
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License Number State | KY
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