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General NPI Number Information
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NPI Number | 1396267530
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Entity Type | Organization
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Legal Business Name | MIDWEST HEALTH GROUP LLC
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1420 E MCMILLAN ST FL 3
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City | CINCINNATI
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State | OH
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Zip | 45206-2225
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Country | US
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Telephone | 513-236-0054
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Fax | 513-332-9155
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Provider Business Mailing Address
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Address Line | 1420 E MCMILLAN ST FL 3
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City | CINCINNATI
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State | OH
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Zip | 45206-2225
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Country | US
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Telephone | 513-236-0054
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Fax | 513-332-9155
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Authorized Official
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Title or Position | OWNER
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Name | KELLIE BOYD BARNES
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Credential | MD
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Telephone | 513-236-0054
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35083658
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License Number State | OH
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