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General NPI Number Information
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NPI Number | 1205118361
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Entity Type | Individual
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Provider Name | SHAKEILLA LAVERN SMITHBEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/15/2011
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 6912 FM 1488 RD STE A
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City | MAGNOLIA
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State | TX
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Zip | 77354-1527
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Country | US
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Telephone | 832-766-0631
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Fax | 281-419-6599
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Provider Business Mailing Address
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Address Line | 54 E 5TH ST APT 2
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City | BAYONNE
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State | NJ
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Zip | 07002-4219
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Country | US
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Telephone | 856-562-0195
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 25MA10007400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 457896
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 53081
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | U5612
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License Number State | TX
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