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General NPI Number Information
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NPI Number | 1093913428
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Entity Type | Organization
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Legal Business Name | VAIOWACITYHEALTH CARE SYSTEM
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Dates
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Enumeration Date | 07/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5725 KILKENNY PL
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City | FITCHBURG
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State | WI
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Zip | 53711-6965
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Country | US
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Telephone | 608-270-1791
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Fax |
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Provider Business Mailing Address
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Address Line | 5725 KILKENNY PL
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City | FITCHBURG
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State | WI
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Zip | 53711-6965
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Country | US
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Telephone | 608-270-1791
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Fax |
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Authorized Official
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Title or Position | RADIOLOGIST
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Name | DR. ROBERT ALLEN VINCENT
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Credential | M.D.
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Telephone | 608-270-1791
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 17720-020
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License Number State | WI
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