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General NPI Number Information
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NPI Number | 1093828600
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Entity Type | Individual
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Provider Name | THOMAS L HUSTED MD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 10/30/2020
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Provider Practice Location Address
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Address Line | 2123 AUBURN AVE
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City | CINCINNATI
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State | OH
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Zip | 45219-2906
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Country | US
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Telephone | 513-585-2062
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Fax | 513-585-3845
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Provider Business Mailing Address
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Address Line | 4760 E GALBRAITH RD STE 108
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City | CINCINNATI
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State | OH
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Zip | 45236-6704
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Country | US
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Telephone | 513-686-5392
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Fax | 513-686-5394
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35.083130
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License Number State | OH
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