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General NPI Number Information
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NPI Number | 1689681967
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Entity Type | Individual
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Provider Name | SHELBY P SANFORD MD
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Gender | Male
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 1410 MCFARLAND BLVD N
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City | TUSCALOOSA
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State | AL
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Zip | 35406-2209
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Country | US
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Telephone | 205-345-8208
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Fax | 205-345-8209
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Provider Business Mailing Address
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Address Line | 1400 AFFLINK PL STE 100
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City | TUSCALOOSA
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State | AL
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Zip | 35406-2289
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Country | US
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Telephone | 205-366-9740
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Fax | 205-344-9992
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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 | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 10900
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License Number State | AL
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