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General NPI Number Information
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NPI Number | 1548532385
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Entity Type | Individual
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Provider Name | DR. DWAYNE L JONES SR.
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Gender | Male
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Dates
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Enumeration Date | 02/08/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 2010 E GEORGIA ST
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City | BARTOW
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State | FL
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Zip | 33830-6709
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Country | US
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Telephone | 863-534-5280
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Fax |
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Provider Business Mailing Address
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Address Line | 13213 SHADY STABLES LN
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City | DOVER
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State | FL
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Zip | 33527-4761
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Country | US
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Telephone | 813-215-9855
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | PS39400
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License Number State | FL
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