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General NPI Number Information
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NPI Number | 1275724411
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Entity Type | Individual
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Provider Name | MARCIA ELAINE MITCHELL M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 01/20/2015
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Provider Practice Location Address
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Address Line | 221 PECAN PARK AVE
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3361
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Country | US
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Telephone | 318-487-1602
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Fax | 318-487-1603
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Provider Business Mailing Address
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Address Line | 221 PECAN PARK AVE
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3361
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Country | US
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Telephone | 318-487-1602
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Fax | 318-487-1603
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | ME93742
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | ME93742
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License Number State | FL
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