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General NPI Number Information
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NPI Number | 1700286598
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Entity Type | Organization
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Legal Business Name | HOMETOWN FAMILY CLINIC OF CYNTHIANA
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Dates
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Enumeration Date | 08/28/2014
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Last Update Date | 08/28/2014
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Provider Practice Location Address
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Address Line | 1134 US HIGHWAY 27 S SUITE 2
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City | CYNTHIANA
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State | KY
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Zip | 41031-4177
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Country | US
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Telephone | 859-234-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 1134 US HIGHWAY 27 S SUITE 2
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City | CYNTHIANA
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State | KY
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Zip | 41031-4177
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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 | OWNER
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Name | DR. MICHAEL INGRAM
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Credential |
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Telephone | 859-234-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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