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General NPI Number Information
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NPI Number | 1467460550
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Entity Type | Individual
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Provider Name | DR. MARK F HUTSON
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Gender | Male
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2415 EXPOSITION BLVD SUITE D
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City | AUSTIN
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State | TX
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Zip | 78703-2271
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Country | US
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Telephone | 512-477-2282
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Fax | 512-477-2336
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Provider Business Mailing Address
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Address Line | 604 LAKEWAY DR
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City | LAKEWAY
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State | TX
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Zip | 78734-4430
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Country | US
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Telephone | 512-261-0855
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 02320T
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License Number State | TX
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