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NPI 1104197276

NPI 1104197276 : JOSEPH R HOLLEN M.D. : RENO, NV

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General NPI Number Information
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    NPI Number           |    1104197276
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    Entity Type          |    Individual 
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    Provider Name        |    JOSEPH R HOLLEN M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/21/2012
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    Last Update Date     |    01/21/2012
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Provider Practice Location Address
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    Address Line         |    4741 CAUGHLIN PKWY SUITE #3
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    City                 |    RENO
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    State                |    NV
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    Zip                  |    89519-1000
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    Country              |    US
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    Telephone            |    775-827-0670
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    Fax                  |    775-827-6481
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Provider Business Mailing Address
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    Address Line         |    PO BOX 6629 
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    City                 |    RENO
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    State                |    NV
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    Zip                  |    89513-6629
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    Country              |    US
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    Telephone            |    775-827-0670
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    Fax                  |    775-827-6481
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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        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    4392
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    License Number State |    NV
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Taxonomy #2
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    Taxonomy Code        |    208D00000X
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    Taxonomy Name        |    General Practice Physician
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    License Number       |    4392
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    License Number State |    NV
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