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General NPI Number Information
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NPI Number | 1124034012
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Entity Type | Individual
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Provider Name | CARRIE L SLOAN M.D.LLC
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 01/28/2022
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Provider Practice Location Address
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Address Line | 96 E KIMBALLS LN STE 202
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City | DRAPER
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State | UT
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Zip | 84020-5021
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Country | US
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Telephone | 801-523-3053
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Fax | 801-523-3059
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Provider Business Mailing Address
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Address Line | PO BOX 198546
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City | ATLANTA
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State | GA
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Zip | 30384-8546
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Country | US
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Telephone |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 5666633-1205
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License Number State | UT
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