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General NPI Number Information
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NPI Number | 1669255790
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Entity Type | Individual
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Provider Name | JEFFREY NEWMAN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 08/14/2023
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Last Update Date | 08/14/2023
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Provider Practice Location Address
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Address Line | 1636 S GLENSTONE AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65804-1506
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Country | US
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Telephone | 417-450-4848
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Fax | 417-450-4049
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Provider Business Mailing Address
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Address Line | 4429 S QUAIL CREEK AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65810-1664
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2019021160
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License Number State | MO
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