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General NPI Number Information
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NPI Number | 1447445317
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Entity Type | Organization
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Legal Business Name | LESLIE STROUSE, M.D., PSC
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Dates
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Enumeration Date | 09/13/2007
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Last Update Date | 09/13/2007
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Provider Practice Location Address
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Address Line | 2625 CHARLESTOWN RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-2536
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Country | US
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Telephone | 812-944-2275
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Fax |
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Provider Business Mailing Address
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Address Line | 2625 CHARLESTOWN RD
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City | NEW ALBANY
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State | IN
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Zip | 47150-2536
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Country | US
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Telephone | 812-944-2275
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | LESLIE STROUSE
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Credential | M.D.
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Telephone | 812-944-2275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 001035535
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License Number State | IN
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