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General NPI Number Information
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NPI Number | 1437141835
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Entity Type | Individual
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Provider Name | ABDUL JABBAR MD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2005
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 2630 GRANT LINE RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-4053
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Country | US
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Telephone | 502-888-1988
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Fax | 812-944-3594
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Provider Business Mailing Address
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Address Line | PO BOX 381468
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City | GERMANTOWN
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State | TN
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Zip | 38183-1468
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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 |
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 01062676A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 35466
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License Number State | KY
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