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General NPI Number Information
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NPI Number | 1609457779
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Entity Type | Organization
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Legal Business Name | GINA VARGAS, M.D. LLC
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 08/13/2021
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Provider Practice Location Address
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Address Line | 4300 ROGERS AVE
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City | FORT SMITH
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State | AR
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Zip | 72903-3143
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Country | US
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Telephone | 479-322-8272
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Fax |
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Provider Business Mailing Address
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Address Line | 2916 KELLS ABBEY
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City | FORT SMITH
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State | AR
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Zip | 72908-9317
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Country | US
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Telephone | 479-322-8272
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. GINA VARGAS
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Credential | MD
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Telephone | 479-322-8272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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