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General NPI Number Information
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NPI Number | 1649467747
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Entity Type | Organization
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Legal Business Name | DEAN SHIPPEY
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Dates
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Enumeration Date | 10/02/2007
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Last Update Date | 11/13/2007
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Provider Practice Location Address
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Address Line | 1600 N MAIN
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City | LOVINGTON
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State | NM
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Zip | 88260
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Country | US
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Telephone | 505-396-7705
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2175
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City | PALESTINE
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State | TX
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Zip | 75802-2175
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Country | US
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Telephone | 903-731-9300
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. LIN STEWART
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Credential |
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Telephone | 903-731-9300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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