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General NPI Number Information
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NPI Number | 1578607149
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Entity Type | Individual
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Provider Name | GARLAND RICHARD BROWN M.D
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Gender | Male
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1007 THREE RIVERS N
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City | FORT WAYNE
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State | IN
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Zip | 46802-1334
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Country | US
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Telephone | 260-422-8821
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Fax | 260-472-6554
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Provider Business Mailing Address
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Address Line | 5522 W HAMILTON RD S
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City | FORT WAYNE
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State | IN
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Zip | 46814-9413
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Country | US
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Telephone | 260-672-2049
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Fax | 260-427-6554
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | IN020308
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License Number State | IN
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