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General NPI Number Information
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NPI Number | 1699449454
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Entity Type | Individual
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Provider Name | JOHN LUIS JEFFCOAT
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Gender | Male
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 204 MEDICAL DR STE 240
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City | SHERMAN
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State | TX
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Zip | 75092-6372
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Country | US
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Telephone | 903-364-4525
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Fax | 877-581-1791
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Provider Business Mailing Address
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Address Line | PO BOX 837
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City | HOWE
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State | TX
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Zip | 75459-0837
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Country | US
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Telephone | 903-364-4525
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Fax | 877-581-1491
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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