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NPI 1568790368

NPI 1568790368 : SILOAM EMERGENCY GROUP LLC : SILOAM SPRINGS, AR

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General NPI Number Information
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    NPI Number           |    1568790368
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    Entity Type          |    Organization 
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    Legal Business Name  |    SILOAM EMERGENCY GROUP LLC 
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Dates
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    Enumeration Date     |    12/07/2009
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    Last Update Date     |    05/14/2012
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Provider Practice Location Address
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    Address Line         |    603 N PROGRESS AVENUE 
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    City                 |    SILOAM SPRINGS
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    State                |    AR
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    Zip                  |    72761-4352
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    Country              |    US
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    Telephone            |    479-525-4141
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    200 CORPORATE BLVD SUITE 201
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    City                 |    LAFAYETTE
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    State                |    LA
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    Zip                  |    70508-3870
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    Country              |    US
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    Telephone            |    800-893-9698
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    DR. WILLIAM C. SCHUMACHER 
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    Credential           |    MD
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    Telephone            |    800-893-9698
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363A00000X
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    Taxonomy Name        |    Physician Assistant
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    363L00000X
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    Taxonomy Name        |    Nurse Practitioner
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    
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    License Number State |    
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