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General NPI Number Information
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NPI Number | 1437785359
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Entity Type | Individual
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Provider Name | JACOB HAROLD THOMAS HORNBUCKLE MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 08/01/2024
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Provider Practice Location Address
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Address Line | 2900 12TH AVE N STE 205W
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City | BILLINGS
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State | MT
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Zip | 59101-7520
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Country | US
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Telephone | 406-254-0707
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Fax | 406-254-0709
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Provider Business Mailing Address
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Address Line | 1959 PACIFIC ST BOX 356540
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City | SEATTLE
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State | WA
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Zip | 98195-0001
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Country | US
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Telephone | 206-543-2474
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Fax | 206-543-2958
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 140187
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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