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General NPI Number Information
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NPI Number | 1073930020
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Entity Type | Individual
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Provider Name | SETH JAMES COYNOR D.O.
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Gender | Male
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Dates
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Enumeration Date | 03/27/2014
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Last Update Date | 11/08/2022
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Provider Practice Location Address
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Address Line | 148 13TH ST
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City | TELL CITY
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State | IN
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Zip | 47586-1937
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Country | US
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Telephone | 812-547-9661
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Fax | 812-547-0281
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Provider Business Mailing Address
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Address Line | 148 13TH ST
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City | TELL CITY
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State | IN
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Zip | 47586-1937
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Country | US
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Telephone | 812-547-9661
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Fax | 812-547-0281
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 10549594-1204
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 02006188
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License Number State | IN
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