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General NPI Number Information
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NPI Number | 1396344784
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Entity Type | Organization
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Legal Business Name | CORE PSYCHIATRY INC.
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Dates
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Enumeration Date | 10/18/2020
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Last Update Date | 01/13/2021
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Provider Practice Location Address
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Address Line | 1011 W POPLAR AVE STE 7
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2577
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Country | US
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Telephone | 901-446-0226
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Fax |
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Provider Business Mailing Address
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Address Line | 1011 W POPLAR AVE STE 7
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City | COLLIERVILLE
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State | TN
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Zip | 38017-2577
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Country | US
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Telephone | 901-446-0226
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Fax | 901-422-5409
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATION
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Name | JASON ERIC BRUNO
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Credential |
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Telephone | 901-446-0226
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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