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General NPI Number Information
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NPI Number | 1689742579
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Entity Type | Individual
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Provider Name | JOHN ANTHONY SEIKEL PH.D.
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Gender | Male
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Dates
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Enumeration Date | 12/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 638 E. DUNN ST. IDAHO STATE UNIVERSITY
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City | POCATELLO
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State | ID
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Zip | 83201-8116
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Country | US
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Telephone | 208-282-4037
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Fax |
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Provider Business Mailing Address
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Address Line | 367 W MCNABB RD
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City | INKOM
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State | ID
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Zip | 83245-1502
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Country | US
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Telephone | 208-775-3183
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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 | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SLP-1185
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License Number State | ID
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