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NPI 1295006476

NPI 1295006476 : LINDSEY ERIN HEAD P.A.-C : ALVA, OK

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General NPI Number Information
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    NPI Number           |    1295006476
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    Entity Type          |    Individual 
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    Provider Name        |    LINDSEY ERIN HEAD P.A.-C
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/20/2012
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    Last Update Date     |    01/25/2016
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Provider Practice Location Address
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    Address Line         |    410 4TH ST SUITES A & B
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    City                 |    ALVA
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    State                |    OK
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    Zip                  |    73717-2372
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    Country              |    US
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    Telephone            |    580-430-3328
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    Fax                  |    580-430-3376
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Provider Business Mailing Address
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    Address Line         |    410 4TH ST SUITES A & B
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    City                 |    ALVA
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    State                |    OK
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    Zip                  |    73717-2372
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    Country              |    US
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    Telephone            |    580-430-3328
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    Fax                  |    580-430-3376
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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        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    2079
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    License Number State |    OK
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