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General NPI Number Information
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NPI Number | 1235118258
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Entity Type | Individual
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Provider Name | MARK STANCHFIELD O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 04/30/2009
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Provider Practice Location Address
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Address Line | 226 9TH AVE SE
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City | CUT BANK
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State | MT
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Zip | 59427-3332
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Country | US
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Telephone | 406-873-5623
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Fax | 406-873-5624
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Provider Business Mailing Address
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Address Line | 226 9TH AVE SE
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City | CUT BANK
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State | MT
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Zip | 59427-3332
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Country | US
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Telephone | 406-873-5623
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Fax | 406-873-5624
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 516
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License Number State | MT
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