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General NPI Number Information
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NPI Number | 1245491026
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Entity Type | Organization
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Legal Business Name | CHARLES W CADENHEAD M D
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 10/09/2008
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Provider Practice Location Address
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Address Line | 1417 NORTH 1ST ST SUITE A
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City | HASKELL
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State | TX
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Zip | 79521-0938
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Country | US
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Telephone | 940-864-2636
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Fax | 940-864-3009
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Provider Business Mailing Address
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Address Line | 1417 NORTH 1ST ST SUITE A
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City | HASKELL
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State | TX
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Zip | 79521-0938
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Country | US
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Telephone | 940-864-2636
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Fax | 940-864-3009
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Authorized Official
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Title or Position | OWNER
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Name | MR. CHARLES WAYNE CADENHEAD
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Credential | MD
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Telephone | 940-864-2636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | E4241
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License Number State | TX
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