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General NPI Number Information
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NPI Number | 1477604817
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Entity Type | Individual
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Provider Name | MARK S BOX MD
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Gender | Male
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Dates
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Enumeration Date | 01/14/2007
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Last Update Date | 03/22/2021
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Provider Practice Location Address
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Address Line | 1010 CARONDELET DR SUITE 224A
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City | KANSAS CITY
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State | MO
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Zip | 64114-4859
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Country | US
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Telephone | 913-563-6644
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Fax | 816-943-6122
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Provider Business Mailing Address
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Address Line | 12639 OLD TESSON RD SUITE 100
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City | SAINT LOUIS
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State | MO
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Zip | 63128-2786
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Country | US
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Telephone | 913-563-6644
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Fax | 816-943-6122
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 04-26764
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | R1J62
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License Number State | MO
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