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General NPI Number Information
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NPI Number | 1124600507
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Entity Type | Individual
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Provider Name | CLAY J CLARDY RPH
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Gender | Male
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Dates
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Enumeration Date | 04/25/2021
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Last Update Date | 04/25/2021
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Provider Practice Location Address
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Address Line | 1801 N MAIN ST
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City | MADISONVILLE
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State | KY
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Zip | 42431-9024
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Country | US
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Telephone | 270-821-0377
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Fax | 270-821-2395
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Provider Business Mailing Address
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Address Line | 907 BELLEMEADE AVE
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City | EVANSVILLE
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State | IN
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Zip | 47713-2325
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Country | US
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Telephone | 502-931-6144
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 010842
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License Number State | KY
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