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General NPI Number Information
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NPI Number | 1578713343
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Entity Type | Individual
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Provider Name | CYRIL N PHILIP MD
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Gender | Male
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 11/30/2021
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Provider Practice Location Address
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Address Line | 850 GENEVA PARKWAY N STE 100
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City | LAKE GENEVA
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State | WI
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Zip | 53147-4562
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Country | US
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Telephone | 262-299-6199
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Fax | 262-293-6953
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Provider Business Mailing Address
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Address Line | 850 GENEVA PARKWAY N STE 100
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City | LAKE GENEVA
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State | WI
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Zip | 53147-4562
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Country | US
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Telephone | 262-299-6199
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Fax | 262-293-6953
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 55669
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 55669
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License Number State | WI
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