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General NPI Number Information
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NPI Number | 1427631589
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Entity Type | Organization
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Legal Business Name | PALLIATIVE HEALTH SOLUTIONS LLC
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 1501 S WALDRON RD STE 208
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City | FORT SMITH
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State | AR
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Zip | 72903-2565
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Country | US
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Telephone | 914-325-2103
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12883
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City | OKLAHOMA CITY
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State | OK
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Zip | 73157-2883
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | JESSIELA ROBERTS
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Credential | MD
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Telephone | 479-401-2123
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Anesthesiology) Physician
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License Number |
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License Number State |
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