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General NPI Number Information
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NPI Number | 1487761151
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Entity Type | Individual
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Provider Name | MARILYN K MCLEOD MD
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Gender | Female
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Dates
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Enumeration Date | 08/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1400 E UNION ST
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City | GREENVILLE
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State | MS
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Zip | 38703-3246
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Country | US
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Telephone | 662-378-3783
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 23998
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City | JACKSON
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State | MS
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Zip | 39225-3998
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Country | US
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Telephone | 662-725-2749
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Fax | 662-725-2741
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 14963
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License Number State | MS
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