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General NPI Number Information
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NPI Number | 1508837998
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Entity Type | Individual
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Provider Name | JAMES JOHN WISDO DO
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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 | 07/21/2020
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Provider Practice Location Address
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Address Line | 2685 SW 32ND PL STE 500
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City | OCALA
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State | FL
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Zip | 34471-7867
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Country | US
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Telephone | 352-622-9007
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Fax | 352-622-2179
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Provider Business Mailing Address
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Address Line | PO BOX 830910
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City | OCALA
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State | FL
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Zip | 34483
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Country | US
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Telephone | 352-622-9007
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Fax | 352-622-2179
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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 | OS7546
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License Number State | FL
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