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General NPI Number Information
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NPI Number | 1568780419
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Entity Type | Individual
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Provider Name | JILL STEPHANIE COOLEY MD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2010
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 2 PROGRESS POINT PKWY DEPT ANESTHESIOLOGY
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City | O FALLON
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State | MO
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Zip | 63368-2205
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Country | US
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Telephone | 800-862-9980
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Fax | 314-362-1185
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Provider Business Mailing Address
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Address Line | PO BOX 60352
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City | SAINT LOUIS
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State | MO
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Zip | 63160-0352
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Country | US
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Telephone | 800-862-9980
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Fax | 314-362-1185
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2024039181
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License Number State | MO
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