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General NPI Number Information
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NPI Number | 1174610596
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Entity Type | Individual
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Provider Name | F DUANE KOVARIK O.D.
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Gender | Male
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 08/27/2008
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Provider Practice Location Address
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Address Line | 3404 W. 13TH ST. STE 105
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City | GRAND ISLAND
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State | NE
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Zip | 68803-2392
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Country | US
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Telephone | 308-382-6928
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Fax |
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Provider Business Mailing Address
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Address Line | 402 VALLEY VIEW DR.
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City | ORD
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State | NE
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Zip | 68862-1651
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Country | US
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Telephone | 308-728-5778
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 840
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License Number State | NE
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