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General NPI Number Information
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NPI Number | 1508154659
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Entity Type | Individual
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Provider Name | PAUL MARTIS MD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2011
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Last Update Date | 06/15/2018
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Provider Practice Location Address
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Address Line | 23450 COLLEGE BLVD
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City | OLATHE
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State | KS
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Zip | 66061
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Country | US
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Telephone | 913-764-7788
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Fax | 913-764-6088
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Provider Business Mailing Address
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Address Line | 2090 W DARTMOUTH ST
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City | OLATHE
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State | KS
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Zip | 66061-6869
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Country | US
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Telephone | 913-356-8300
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Fax | 913-356-8711
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 04-37376
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License Number State | KS
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