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General NPI Number Information
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NPI Number | 1447683586
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Entity Type | Organization
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Legal Business Name | COMMUNITY FAMILY PRACTICE LLC
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Dates
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Enumeration Date | 08/13/2013
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Last Update Date | 08/13/2013
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Provider Practice Location Address
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Address Line | 1430 S HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43207-1045
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Country | US
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Telephone | 614-445-6400
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Fax | 614-445-6405
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Provider Business Mailing Address
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Address Line | 1430 S HIGH ST
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City | COLUMBUS
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State | OH
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Zip | 43207-1045
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Country | US
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Telephone | 614-445-6400
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Fax | 614-445-6405
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Authorized Official
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Title or Position | MANAGER
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Name | MR. SCOTT THOMAS STEWART
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Credential |
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Telephone | 614-445-6400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34005855
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License Number State | OH
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