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General NPI Number Information
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NPI Number | 1629967864
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Entity Type | Organization
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Legal Business Name | CLENDENIN MD LLC
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Dates
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Enumeration Date | 07/01/2025
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Last Update Date | 07/01/2025
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Provider Practice Location Address
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Address Line | 1081 N BRYANT AVE
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City | EDMOND
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State | OK
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Zip | 73034-3208
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Country | US
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Telephone | 737-333-2400
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Fax | 405-785-3622
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Provider Business Mailing Address
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Address Line | 2028 E BEN WHITE BLVD STE 240-7980
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City | AUSTIN
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State | TX
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Zip | 78741-6966
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Country | US
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Telephone | 737-333-2400
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Fax | 405-622-4004
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | ROBERT KEELE CLENDENIN
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Credential | MD
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Telephone | 321-220-5000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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