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General NPI Number Information
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NPI Number | 1104849280
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Entity Type | Organization
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Legal Business Name | THE MEDICAL IMAGING PARTNERSHIP-JAX1 LLC
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 7860 GATE PARKWAY SUITE 123
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City | JACKSONVILLE
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State | FL
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Zip | 32256-7279
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Country | US
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Telephone | 904-996-8100
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Fax | 904-996-8101
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Provider Business Mailing Address
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Address Line | PO BOX 96454
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City | CHARLOTTE
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State | NC
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Zip | 28296-0454
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Country | US
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Telephone | 904-996-8100
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Fax | 904-389-8699
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Authorized Official
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Title or Position | CEO
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Name | JOSHUA HAMMOND
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Credential |
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Telephone | 904-996-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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