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General NPI Number Information
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NPI Number | 1487625992
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Entity Type | Individual
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Provider Name | DELON NICHOLAS PA
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Gender | Male
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Dates
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Enumeration Date | 02/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8029 MOSSY CRK
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City | PENSACOLA
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State | FL
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Zip | 32526-8420
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Country | US
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Telephone | 850-944-4718
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Fax | 850-492-4877
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Provider Business Mailing Address
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Address Line | 8029 MOSSY CREEK RD
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City | PENSACOLA
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State | FL
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Zip | 32526
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Country | US
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Telephone | 850-944-4718
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Fax | 850-492-4877
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA 3740
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License Number State | FL
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