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General NPI Number Information
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NPI Number | 1497793541
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Entity Type | Individual
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Provider Name | JAMES L. SMITH CRNA
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 210 MARIE LANGDON DR
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City | MANCHESTER
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State | KY
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Zip | 40962-6388
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Country | US
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Telephone | 606-598-5104
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 33087
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City | KNOXVILLE
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State | TN
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Zip | 37930-3087
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Country | US
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Telephone | 865-691-2993
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Fax | 865-691-2997
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN1105192/ARNP4469A
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License Number State | KY
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