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General NPI Number Information
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NPI Number | 1386035285
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Entity Type | Organization
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Legal Business Name | CERTIFIED ALLERGY, ASTHMA, AND IMMUNOLOGY SPECIALISTS
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 04/28/2015
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Provider Practice Location Address
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Address Line | 2821 N VAN BUREN ST
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City | ENID
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State | OK
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Zip | 73703-1729
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Country | US
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Telephone | 580-213-9799
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Fax | 580-234-2474
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Provider Business Mailing Address
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Address Line | 2821 N VAN BUREN ST
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City | ENID
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State | OK
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Zip | 73703-1729
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Country | US
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Telephone | 580-213-9799
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Fax | 580-234-2474
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Authorized Official
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Title or Position | OWNER
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Name | DR. TIMOTHY D TROJAN
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Credential | M.D.
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Telephone | 580-213-9799
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 29671
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License Number State | OK
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