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General NPI Number Information
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NPI Number | 1205900800
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Entity Type | Individual
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Provider Name | ALISON S. KLENK MD
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Gender | Female
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 545 BARNHILL DR SUITE 139
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5112
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Country | US
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Telephone | 317-944-7744
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Fax | 317-274-3700
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE STE 130 PROVIDER ENROLLMENT
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone |
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 01066269A
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License Number State | IN
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