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General NPI Number Information
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NPI Number | 1689654303
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Entity Type | Individual
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Provider Name | BRYAN J KRAJICEK M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/19/2006
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 1 EDMUNDSON PL
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-4658
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Country | US
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Telephone | 712-396-7810
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Fax | 712-396-4145
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Provider Business Mailing Address
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Address Line | 1 EDMUNDSON PL
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-4658
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Country | US
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Telephone | 712-396-7810
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Fax | 712-396-4145
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 25396
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 38710
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 45765
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License Number State | MN
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