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General NPI Number Information
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NPI Number | 1659524403
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Entity Type | Organization
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Legal Business Name | DOCTOR'S DIAGNOSITCS, LLC
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Dates
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Enumeration Date | 10/24/2008
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Last Update Date | 09/09/2009
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Provider Practice Location Address
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Address Line | 322 HIGHWAY 62 W SUITE 2
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City | SALEM
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State | AR
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Zip | 72576-9566
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Country | US
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Telephone | 870-404-6708
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1171
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City | MOUNTAIN HOME
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State | AR
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Zip | 72654-1171
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Country | US
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Telephone | 870-404-6708
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Fax | 870-425-8275
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. MICHEAL J CAMP
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Credential | MD
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Telephone | 870-425-8288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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