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General NPI Number Information
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NPI Number | 1598867145
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Entity Type | Individual
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Provider Name | KENNETH KELLOGG MAGEE M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/03/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 4745 S 6TH ST
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City | KLAMATH FALLS
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State | OR
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Zip | 97603-4958
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Country | US
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Telephone | 541-882-2902
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Fax |
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Provider Business Mailing Address
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Address Line | 5233 UHRMANN RD
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City | KLAMATH FALLS
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State | OR
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Zip | 97601-9312
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Country | US
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Telephone | 541-884-5253
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD06996
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License Number State | OR
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