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General NPI Number Information
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NPI Number | 1588657324
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Entity Type | Individual
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Provider Name | DAVID WILLIAM DORNHOFFER CRNA
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Gender | Male
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Dates
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Enumeration Date | 08/26/2005
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Last Update Date | 12/06/2019
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Provider Practice Location Address
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Address Line | 603 N PROGRESS AVE
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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 | 479-215-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1547
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City | SEDALIA
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State | MO
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Zip | 65302-1547
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Country | US
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Telephone | 660-826-5960
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Fax | 660-826-4852
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | C000451
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License Number State | AR
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