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General NPI Number Information
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NPI Number | 1235251018
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Entity Type | Organization
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Legal Business Name | ALEXANDER T. KALK, MD, LLC
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 11/27/2007
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Provider Practice Location Address
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Address Line | 11605 STUDT AVE STE 112
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City | SAINT LOUIS
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State | MO
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Zip | 63141-7052
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Country | US
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Telephone | 314-567-6565
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Fax | 314-567-6569
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Provider Business Mailing Address
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Address Line | PO BOX 372045
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City | SAINT LOUIS
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State | MO
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Zip | 63137-7045
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Country | US
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Telephone | 314-567-6565
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Fax | 314-567-6569
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Authorized Official
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Title or Position | PROVIDER - OWNER
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Name | DR. ALEXANDER T. KALK
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Credential | MD
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Telephone | 314-567-6565
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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 |
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License Number State |
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