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General NPI Number Information
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NPI Number | 1699708842
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Entity Type | Organization
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Legal Business Name | FAMILY MEDICAL CLINIC, LLC
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Dates
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Enumeration Date | 07/09/2006
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 1700 NW MOCK AVE
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City | BLUE SPRINGS
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State | MO
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Zip | 64015-3118
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Country | US
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Telephone | 816-224-0400
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Fax | 816-224-0418
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Provider Business Mailing Address
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Address Line | 1700 NW MOCK AVE
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City | BLUE SPRINGS
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State | MO
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Zip | 64015-3118
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Country | US
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Telephone | 816-224-0400
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Fax | 816-224-0418
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Authorized Official
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Title or Position | MANAGER
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Name | ANIL SINGH
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Credential |
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Telephone | 816-945-9596
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 105481
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License Number State | MO
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