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General NPI Number Information
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NPI Number | 1538999222
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Entity Type | Individual
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Provider Name | MADISON JO SIMON AUD
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Gender | Female
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Dates
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Enumeration Date | 08/06/2024
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Last Update Date | 02/10/2025
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Provider Practice Location Address
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Address Line | 2501 E SOUTHERN AVE STE 20
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City | TEMPE
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State | AZ
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Zip | 85282-7667
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Country | US
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Telephone | 480-833-4330
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Fax |
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Provider Business Mailing Address
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Address Line | 7525 E BROADWAY RD STE 7
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City | MESA
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State | AZ
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Zip | 85208-1156
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Country | US
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Telephone | 480-833-4330
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Fax |
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | DA15417
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License Number State | AZ
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