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General NPI Number Information
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NPI Number | 1215973078
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Entity Type | Individual
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Provider Name | JASON ROY D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 08/24/2017
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Provider Practice Location Address
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Address Line | 2695 SHADY TREE DR
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City | TROY
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State | OH
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Zip | 45373-7567
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Country | US
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Telephone | 216-570-2650
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Fax | 888-570-7690
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Provider Business Mailing Address
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Address Line | 2695 SHADY TREE DR
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City | TROY
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State | OH
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Zip | 45373-7567
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Country | US
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Telephone | 216-570-2650
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Fax | 888-570-7690
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 36-00-3321-R
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License Number State | OH
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