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General NPI Number Information
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NPI Number | 1568431393
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Entity Type | Individual
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Provider Name | KENNETH W OLANDER M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/15/2006
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Last Update Date | 05/09/2008
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Provider Practice Location Address
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Address Line | 622 SMITHVIEW DR
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City | MARYVILLE
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State | TN
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Zip | 37803-6100
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Country | US
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Telephone | 865-681-1234
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Fax | 865-982-9746
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Provider Business Mailing Address
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Address Line | 1928 ALCOA HWY SUITE 324
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City | KNOXVILLE
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State | TN
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Zip | 37920-1502
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Country | US
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Telephone | 865-524-9871
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Fax | 865-305-6695
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 029068
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License Number State | TN
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