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General NPI Number Information
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NPI Number | 1356620843
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Entity Type | Organization
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Legal Business Name | J.MICHAEL KERLEY, M.D., PLLC
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Dates
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Enumeration Date | 08/15/2011
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Last Update Date | 02/17/2012
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Provider Practice Location Address
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Address Line | 424 N UTICA AVE
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City | LUBBOCK
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State | TX
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Zip | 79416-3035
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Country | US
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Telephone | 806-776-8200
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Fax | 806-771-4177
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Provider Business Mailing Address
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Address Line | 6565 WEST LOOP S STE 400
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City | BELLAIRE
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State | TX
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Zip | 77401-3500
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Country | US
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Telephone | 713-589-6879
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Fax | 713-795-5801
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Authorized Official
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Title or Position | OWNER
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Name | DR. J MICHAEL KERLEY
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Credential | M.D.
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Telephone | 806-776-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | G3515
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License Number State | TX
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