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General NPI Number Information
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NPI Number | 1336266485
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Entity Type | Individual
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Provider Name | MARJORIE COLEMAN
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Gender | Female
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 12/05/2025
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Provider Practice Location Address
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Address Line | 12128 E BECKER DR
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City | VAIL
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State | AZ
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Zip | 85641-6880
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Country | US
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Telephone | 520-236-9023
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 86537
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City | TUCSON
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State | AZ
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Zip | 85754-6537
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Country | US
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Telephone | 520-721-1887
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Fax | 520-407-5398
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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 | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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