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General NPI Number Information
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NPI Number | 1558355008
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Entity Type | Individual
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Provider Name | SUNITA K JAIN MD
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Gender | Female
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Dates
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Enumeration Date | 09/09/2005
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Last Update Date | 08/23/2024
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Provider Practice Location Address
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Address Line | 6029 WALNUT GROVE RD STE 209
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City | MEMPHIS
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State | TN
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Zip | 38120-2112
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Country | US
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Telephone | 901-681-0778
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Fax | 901-821-9987
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Provider Business Mailing Address
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Address Line | PO BOX 341226
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City | BARTLETT
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State | TN
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Zip | 38184-1226
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Country | US
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Telephone | 901-291-2400
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Fax | 901-379-0771
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 26446
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License Number State | TN
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