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General NPI Number Information
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NPI Number | 1245729870
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Entity Type | Individual
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Provider Name | MARK LOUIS SIEFRING MD
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Gender | Male
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Dates
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Enumeration Date | 05/09/2018
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Last Update Date | 08/11/2025
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Provider Practice Location Address
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Address Line | 1250 BARDSTOWN RD STE 8
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City | LOUISVILLE
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State | KY
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Zip | 40204-1333
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Country | US
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Telephone | 502-456-7047
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Fax | 502-452-1491
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Provider Business Mailing Address
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Address Line | PO BOX 776351
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City | CHICAGO
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State | IL
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Zip | 60677-6351
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Country | US
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Telephone | 502-588-9490
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Fax | 502-272-5116
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD203727
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 34079
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License Number State | KY
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