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General NPI Number Information
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NPI Number | 1679709026
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Entity Type | Organization
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Legal Business Name | SIZEMORE FAMILY VISION CARE,LLC
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Dates
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Enumeration Date | 05/29/2009
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Last Update Date | 05/29/2009
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Provider Practice Location Address
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Address Line | 1463 W WESTRIDGE PKWY SUITE B
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City | GREENSBURG
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State | IN
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Zip | 47240-3252
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Country | US
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Telephone | 812-662-6000
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Fax | 812-662-6009
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Provider Business Mailing Address
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Address Line | 1463 W WESTRIDGE PKWY SUITE B
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City | GREENSBURG
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State | IN
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Zip | 47240-3252
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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 | OWNER
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Name | DR. CARRIE ANN SIZEMORE
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Credential | O.D.
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Telephone | 812-662-6000
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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 | 18003440
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License Number State | IN
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