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General NPI Number Information
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NPI Number | 1548230881
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Entity Type | Organization
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Legal Business Name | PULMONARY MEDICINE CLINIC PA
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1710 W 42ND AVE
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City | PINE BLUFF
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State | AR
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Zip | 71603-7008
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Country | US
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Telephone | 870-536-8507
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Fax | 870-536-8541
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Provider Business Mailing Address
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Address Line | 1710 W 42ND AVE
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City | PINE BLUFF
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State | AR
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Zip | 71603-7008
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Country | US
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Telephone | 870-536-8507
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Fax | 870-536-8541
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES CLYDE CAMPBELL
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Credential | M.D.
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Telephone | 870-536-8507
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | C-4368
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License Number State | AR
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