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General NPI Number Information
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NPI Number | 1134974553
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Entity Type | Organization
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Legal Business Name | WEST POINT LLC
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Dates
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Enumeration Date | 04/19/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 402 S MAIN ST
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City | DE WITT
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State | AR
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Zip | 72042-2618
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Country | US
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Telephone | 870-946-0079
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Fax | 870-946-0090
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Provider Business Mailing Address
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Address Line | PO BOX 286
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City | DE WITT
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State | AR
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Zip | 72042-0286
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Country | US
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Telephone | 870-946-0198
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Fax | 870-946-0220
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Authorized Official
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Title or Position | APRN
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Name | MRS. DEBRA CHARLENE WEST
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Credential | APRN
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Telephone | 870-946-0198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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