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General NPI Number Information
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NPI Number | 1124447263
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Entity Type | Organization
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Legal Business Name | VICTOR HULTSTRAND LLC
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 04/15/2014
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Provider Practice Location Address
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Address Line | 4724 N DAVIS HWY # 200
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City | PENSACOLA
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State | FL
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Zip | 32503-2339
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Country | US
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Telephone | 850-607-7185
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Fax |
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Provider Business Mailing Address
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Address Line | 70 ROCKWOOD RD
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City | PENSACOLA
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State | FL
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Zip | 32514-8109
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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 | OWNER
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Name | VICTOR HULTSTRAND
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Credential | M.D.
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Telephone | 850-607-7185
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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