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General NPI Number Information
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NPI Number | 1114011988
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Entity Type | Individual
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Provider Name | JULIA EASTON KAUFMAN MD
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Gender | Female
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 12/03/2009
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Provider Practice Location Address
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Address Line | 5665 NEW NORTHSIDE DR NW SUITE 320
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City | ATLANTA
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State | GA
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Zip | 30328-5831
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Country | US
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Telephone | 310-429-6470
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Fax |
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Provider Business Mailing Address
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Address Line | 5245 STERLING COVE CT
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City | MABLETON
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State | GA
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Zip | 30126-7615
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Country | US
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Telephone | 770-739-9850
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Fax |
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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 | 2080P0204X
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Taxonomy Name | Pediatric Emergency Medicine (Pediatrics) Physician
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License Number | A86246
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 61276
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License Number State | GA
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