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General NPI Number Information
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NPI Number | 1699054825
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Entity Type | Organization
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Legal Business Name | INDIANA UNIVERSITY SCHOOL OF MEDICINE
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Dates
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Enumeration Date | 08/05/2011
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Last Update Date | 08/05/2011
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Provider Practice Location Address
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Address Line | 541 CLINICAL DR STE 600
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-5233
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Country | US
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Telephone | 317-274-3291
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Fax |
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Provider Business Mailing Address
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Address Line | 6650 PANTHER WAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-9475
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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 | RESIDENT DOCTOR
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Name | DR. JONATHAN SCOTT HARRIS
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Credential |
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Telephone | 706-599-3619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 11015944A
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License Number State | IN
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