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General NPI Number Information
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NPI Number | 1639585763
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Entity Type | Individual
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Provider Name | ASHLEY JANELLE LAMASTER O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/09/2014
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 1201 CROSS POINTE PL
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City | EVANSVILLE
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State | IN
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Zip | 47715-9168
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Country | US
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Telephone | 812-909-6587
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Fax |
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Provider Business Mailing Address
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Address Line | 300 LANT LN
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City | EVANSVILLE
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State | IN
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Zip | 47715-3400
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Country | US
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Telephone | 812-345-4161
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 18003861
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License Number State | IN
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