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General NPI Number Information
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NPI Number | 1366187817
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Entity Type | Individual
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Provider Name | REYNALDO ALBERTO GOMEZ ESCALONA MD
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Gender | Male
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Dates
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Enumeration Date | 04/29/2022
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 1008 S SPRING AVE RM 2315
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City | SAINT LOUIS
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State | MO
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Zip | 63110-2520
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Country | US
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Telephone | 314-617-3561
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Fax | 314-977-8818
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Provider Business Mailing Address
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Address Line | 1008 S SPRING AVE RM 2315
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City | SAINT LOUIS
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State | MO
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Zip | 63110-2520
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Country | US
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Telephone | 314-617-3561
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Fax | 314-977-8818
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | R79436
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License Number State | AZ
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