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General NPI Number Information
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NPI Number | 1184465056
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Entity Type | Individual
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Provider Name | DREW CASEY OD
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Gender | Male
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 08/12/2024
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Provider Practice Location Address
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Address Line | 9000 MENAUL BLVD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87112-2231
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Country | US
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Telephone | 505-219-3113
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Fax | 505-792-6608
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Provider Business Mailing Address
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Address Line | 3114 TESS CT NE
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City | RIO RANCHO
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State | NM
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Zip | 87144-1473
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Country | US
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Telephone | 614-456-9797
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT-2024-0009
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License Number State | NM
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