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General NPI Number Information
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NPI Number | 1215985593
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Entity Type | Individual
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Provider Name | JAY WALTER HELGASON M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 11/08/2018
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Provider Practice Location Address
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Address Line | 1111 MEDICAL CENTER BLVD
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City | MARRERO
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State | LA
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Zip | 70072-3151
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Country | US
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Telephone | 504-349-1461
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Fax | 504-349-1461
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Provider Business Mailing Address
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Address Line | PO BOX 6750
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City | PORTSMOUTH
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State | NH
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Zip | 03802-6750
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Country | US
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Telephone | 800-208-7069
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Fax | 610-956-0020
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 021442
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License Number State | LA
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