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General NPI Number Information
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NPI Number | 1295727568
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Entity Type | Individual
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Provider Name | CLIFFORD M. MYLES M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 725 S JAMES CAMPBELL BLVD
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City | COLUMBIA
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State | TN
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Zip | 38401-5962
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Country | US
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Telephone | 931-381-3700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 299
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City | MANCHESTER
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State | TN
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Zip | 37349-0299
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Country | US
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Telephone | 931-728-5607
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Fax | 931-728-8354
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD30260
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License Number State | TN
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