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General NPI Number Information
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NPI Number | 1447233218
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Entity Type | Individual
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Provider Name | MARK DOUGLAS LIGNELL MD
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Gender | Male
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Dates
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Enumeration Date | 11/24/2005
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Last Update Date | 06/26/2025
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Provider Practice Location Address
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Address Line | 16 JOHN MADDOX DR NW
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City | ROME
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State | GA
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Zip | 30165-1414
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Country | US
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Telephone | 706-802-3727
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Fax |
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Provider Business Mailing Address
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Address Line | 21 TRIMBLE WAY SE
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City | ROME
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State | GA
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Zip | 30161-7803
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Country | US
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Telephone | 239-961-6988
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 0101230994
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 71527
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License Number State | GA
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