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General NPI Number Information
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NPI Number | 1124126297
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Entity Type | Individual
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Provider Name | ROY H BOONE JR. MD
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 805 FRONTAGE RD SUITE 130 US DEPARTMENT OF VETERANS AFFAIRS
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City | KENAI
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State | AK
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Zip | 99611
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Country | US
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Telephone | 907-283-2231
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Fax | 907-283-4236
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Provider Business Mailing Address
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Address Line | PO BOX 39181
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City | NINILCHIK
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State | AK
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Zip | 99639
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Country | US
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Telephone | 907-567-4354
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 5186
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME54837
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License Number State | FL
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