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General NPI Number Information
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NPI Number | 1427047695
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Entity Type | Individual
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Provider Name | EDWARD J FARMLETT M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/19/2005
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 87 SPRING ST SUITE 101
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City | LACONIA
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State | NH
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Zip | 03246-3156
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Country | US
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Telephone | 603-524-3211
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Fax | 603-524-0089
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Provider Business Mailing Address
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Address Line | PO BOX 4110 DEPARTMENT 3340
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City | WOBURN
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State | MA
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Zip | 01888-4110
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Country | US
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Telephone | 603-524-3211
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Fax | 603-524-0089
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 7611
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License Number State | NH
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