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General NPI Number Information
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NPI Number | 1578164497
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Entity Type | Organization
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Legal Business Name | PENSACOLA HOSPITALIST PHYSICIANS, LLC
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Dates
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Enumeration Date | 11/06/2020
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 1110 GULF BREEZE PKWY
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City | GULF BREEZE
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State | FL
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Zip | 32561-4884
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Country | US
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Telephone | 850-934-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 5665 NEW NORTHSIDE DR STE 320
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City | ATLANTA
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State | GA
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Zip | 30328-5834
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Country | US
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Telephone | 770-874-5400
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF CREDENTIALING
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Name | KIM LARSEN
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Credential |
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Telephone | 770-874-5400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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