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General NPI Number Information
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NPI Number | 1093988230
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Entity Type | Individual
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Provider Name | LESLIE ANN RENFRO M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/09/2008
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Last Update Date | 06/28/2013
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Provider Practice Location Address
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Address Line | 1120 SOUTH DRIVER FESLER HALL, ROOM 204
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5135
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Country | US
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Telephone | 317-274-0269
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Fax | 317-273-0256
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Provider Business Mailing Address
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Address Line | PO BOX 6069-DEPT 106
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City | INDIANAPOLIS
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State | IN
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Zip | 46206-6069
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Country | US
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Telephone | 317-614-9850
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Fax | 800-731-0699
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 01069273A
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License Number State | IN
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