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General NPI Number Information
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NPI Number | 1558565168
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Entity Type | Organization
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Legal Business Name | LEWIS B KIZER
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Dates
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Enumeration Date | 06/14/2007
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Last Update Date | 08/09/2023
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Provider Practice Location Address
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Address Line | 2081 SOUTH MAIN ST
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City | MILAN
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State | TN
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Zip | 38358-3011
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Country | US
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Telephone | 731-686-8642
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Fax | 731-686-7622
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Provider Business Mailing Address
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Address Line | PO BOX 548
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City | MILAN
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State | TN
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Zip | 38358-0548
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Country | US
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Telephone | 731-686-8642
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Fax | 731-686-7622
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Authorized Official
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Title or Position | OWNER
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Name | DR. LEWIS BOND KIZER
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Credential | OD
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Telephone | 731-686-8642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 762
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License Number State | TN
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