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General NPI Number Information
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NPI Number | 1689173981
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Entity Type | Organization
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Legal Business Name | MAO LEAWOOD SURGERY CENTER LLC
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Dates
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Enumeration Date | 02/02/2018
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Last Update Date | 02/02/2018
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Provider Practice Location Address
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Address Line | 4940 W 137TH STREET
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City | LEAWOOD
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State | KS
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Zip | 66224
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Country | US
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Telephone | 316-866-2540
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Fax |
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Provider Business Mailing Address
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Address Line | 1923 N WEBB RD
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City | WICHITA
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State | KS
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Zip | 67206-3405
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Country | US
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Telephone | 316-300-6515
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Fax |
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Authorized Official
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Title or Position | MANAGEMENT
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Name | MARY CHAU-NGUYEN
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Credential |
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Telephone | 316-300-6515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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