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General NPI Number Information
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NPI Number | 1255009304
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Entity Type | Individual
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Provider Name | JOHN M. JONES DO
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Gender | Male
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 7622 W PIUTE AVE
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City | GLENDALE
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State | AZ
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Zip | 85308-6091
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Country | US
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Telephone | 702-202-5780
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Fax |
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Provider Business Mailing Address
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Address Line | 129 BROKEN ARROW TRL
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City | PETAL
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State | MS
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Zip | 39465-8953
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Country | US
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Telephone | 702-202-5780
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2447
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License Number State | AZ
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