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General NPI Number Information
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NPI Number | 1356920656
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Entity Type | Individual
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Provider Name | ALBERT VACHERON MD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2021
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Last Update Date | 08/07/2025
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Provider Practice Location Address
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Address Line | 202 N 1ST ST
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City | BOONEVILLE
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State | MS
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Zip | 38829-2718
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Country | US
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Telephone | 662-340-1138
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Fax | 662-728-5185
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Provider Business Mailing Address
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Address Line | 350 N HUMPHREYS BLVD
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City | MEMPHIS
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State | TN
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Zip | 38120-2177
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Country | US
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Telephone | 901-226-4003
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Fax | 901-227-8591
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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 | 207RS0012X
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Taxonomy Name | Sleep Medicine (Internal Medicine) Physician
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License Number | 34844
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 73859
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License Number State | MS
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