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General NPI Number Information
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NPI Number | 1700097961
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Entity Type | Individual
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Provider Name | JOSEPH THOMAS POPE OD
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Gender | Male
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Dates
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Enumeration Date | 05/26/2007
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Last Update Date | 11/03/2008
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Provider Practice Location Address
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Address Line | 1120 E MANANA BLVD
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City | CLOVIS
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State | NM
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Zip | 88101-3822
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Country | US
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Telephone | 575-769-1010
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Fax | 575-769-1010
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Provider Business Mailing Address
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Address Line | 1120 E MANANA BLVD
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City | CLOVIS
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State | NM
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Zip | 88101-3822
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Country | US
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Telephone | 575-769-1010
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Fax | 575-769-1010
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | NM309
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License Number State | NM
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