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General NPI Number Information
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NPI Number | 1659373801
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Entity Type | Individual
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Provider Name | ROBERT J STILL MD
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 11/22/2022
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Provider Practice Location Address
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Address Line | 1893 KINGSLEY AVE STE A
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City | ORANGE PARK
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State | FL
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Zip | 32073
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Country | US
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Telephone | 904-592-4940
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Fax | 904-400-6673
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Provider Business Mailing Address
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Address Line | 1824 KING ST STE 200
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City | JACKSONVILLE
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State | FL
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Zip | 32204-4735
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Country | US
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Telephone | 904-384-3343
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Fax | 904-400-6671
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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 | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | ME59783
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License Number State | FL
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