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General NPI Number Information
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NPI Number | 1528560281
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Entity Type | Organization
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Legal Business Name | VENTURE HOSPITALIST, LLC
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Dates
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Enumeration Date | 03/08/2018
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Last Update Date | 08/17/2018
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Provider Practice Location Address
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Address Line | 301 8TH AVE SW
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City | MAGEE
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State | MS
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Zip | 39111-3967
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Country | US
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Telephone | 601-955-1977
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 785
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City | MAGEE
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State | MS
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Zip | 39111-0785
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Country | US
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Telephone | 601-955-1977
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KIM MCNULTY
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Credential |
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Telephone | 601-955-1977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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