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General NPI Number Information
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NPI Number | 1467523365
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Entity Type | Individual
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Provider Name | JOHN G LIEB II MD
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Gender | Male
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 03/09/2020
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Provider Practice Location Address
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Address Line | 1600 SW ARCHER RD
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City | GAINESVILLE
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State | FL
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Zip | 32610-4238
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Country | US
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Telephone | 352-392-2877
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Fax | 352-392-3618
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Provider Business Mailing Address
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Address Line | 1600 SW ARCHER RD BOX 100214
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City | GAINESVILLE
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State | FL
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Zip | 32610-0214
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Country | US
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Telephone | 352-392-2877
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Fax | 352-392-3618
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | MD428599
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME101188
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License Number State | FL
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