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General NPI Number Information
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NPI Number | 1114554045
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Entity Type | Individual
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Provider Name | SYDNI KAYE DAVIS FARHAT OD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 10/14/2020
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Provider Practice Location Address
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Address Line | 5865 W UTOPIA RD
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City | GLENDALE
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State | AZ
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Zip | 85308-5251
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Country | US
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Telephone | 623-537-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 43 BONHOMME RICHARD CT
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City | SAINT CHARLES
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State | MO
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Zip | 63303-1761
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Country | US
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Telephone | 314-941-9818
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2020014779
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 002432
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License Number State | AZ
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