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General NPI Number Information
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NPI Number | 1154895670
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Entity Type | Organization
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Legal Business Name | FOUST MEDICAL CLINIC, LLC
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Dates
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Enumeration Date | 01/17/2019
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Last Update Date | 05/28/2025
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Provider Practice Location Address
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Address Line | 849 VOLUNTEER DR STE 2
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City | PARIS
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State | TN
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Zip | 38242-5483
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Country | US
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Telephone | 731-540-7075
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Fax |
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Provider Business Mailing Address
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Address Line | 849 VOLUNTEER DR STE 2
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City | PARIS
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State | TN
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Zip | 38242-5483
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Country | US
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Telephone | 731-540-7075
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Fax | 731-227-2887
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT/OWNER
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Name | DAPHNE T FOUST
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Credential | MPAS, PA-C
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Telephone | 731-540-7075
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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