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General NPI Number Information
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NPI Number | 1629046545
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Entity Type | Individual
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Provider Name | JOHN D COWAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/08/2006
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Last Update Date | 12/13/2011
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Provider Practice Location Address
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Address Line | 907 E LAMAR ALEXANDER PKWY
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City | MARYVILLE
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State | TN
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Zip | 37804-5015
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Country | US
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Telephone | 865-977-4641
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Fax | 865-977-4787
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Provider Business Mailing Address
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Address Line | PO BOX 5629
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City | MARYVILLE
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State | TN
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Zip | 37802-5629
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Country | US
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Telephone | 865-980-4844
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Fax | 865-977-4787
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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 | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | MD0000009032
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207RH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Internal Medicine) Physician
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License Number | 9032
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License Number State | TN
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