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General NPI Number Information
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NPI Number | 1487195756
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Entity Type | Individual
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Provider Name | STEPHEN PACKER MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2017
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 2527 WILDBROOK AVE
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City | NORTH LAS VEGAS
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State | NV
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Zip | 89086-1548
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Country | US
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Telephone | 725-222-0807
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Fax | 707-666-6480
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Provider Business Mailing Address
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Address Line | 3500 POSNER BLVD # 1277
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City | DAVENPORT
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State | FL
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Zip | 33837-3640
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Country | US
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Telephone | 725-222-0807
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Fax | 707-666-6480
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A201373
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 22027
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME147091
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License Number State | FL
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