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General NPI Number Information
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NPI Number | 1104213412
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Entity Type | Individual
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Provider Name | BRYCE ALSTON VANCE D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/24/2015
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Last Update Date | 10/23/2025
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Provider Practice Location Address
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Address Line | 2601 GENE GEORGE BLVD
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City | SPRINGDALE
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State | AR
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Zip | 72762-0845
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Country | US
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Telephone | 479-309-5391
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Fax | 479-725-6582
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Provider Business Mailing Address
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Address Line | 2601 GENE GEORGE BLVD
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City | SPRINGDALE
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State | AR
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Zip | 72762-0845
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Country | US
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Telephone | 479-309-5391
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Fax | 479-725-6582
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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 | DR.0059282
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | E-19652
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License Number State | AR
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Taxonomy #3
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | E-19652
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License Number State | AR
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Taxonomy #4
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | DR.0059282
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License Number State | CO
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