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General NPI Number Information
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NPI Number | 1265402317
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Entity Type | Individual
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Provider Name | THEOLYN N PRICE MD
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Gender | Female
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Dates
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Enumeration Date | 01/23/2006
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Last Update Date | 09/30/2019
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Provider Practice Location Address
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Address Line | 2500 HOSPITAL BLVD STE 420
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City | ROSWELL
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State | GA
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Zip | 30076
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Country | US
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Telephone | 704-249-7327
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Fax | 770-421-0228
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Provider Business Mailing Address
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Address Line | 2500 HOSPITAL BLVD STE 420
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City | ROSWELL
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State | GA
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Zip | 30076-4919
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Country | US
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Telephone | 704-249-7327
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Fax | 770-421-0228
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 45827
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | ME110622
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 52769
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License Number State | CO
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 80819
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License Number State | GA
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