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General NPI Number Information
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NPI Number | 1497744577
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Entity Type | Individual
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Provider Name | SCOTT JOSEPH COOLE D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/20/2005
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Last Update Date | 03/02/2022
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Provider Practice Location Address
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Address Line | 1851 MESQUITE AVE STE 210
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86403-5681
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Country | US
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Telephone | 928-854-7540
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Fax | 928-854-2505
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Provider Business Mailing Address
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Address Line | 330 SEVEN SPRINGS WAY
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City | BRENTWOOD
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State | TN
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Zip | 37027-5098
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Country | US
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Telephone | 615-920-7782
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Fax | 615-920-8775
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 176625
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License Number State | AZ
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