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General NPI Number Information
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NPI Number | 1710292289
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Entity Type | Organization
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Legal Business Name | UTES FAMILY PRACTICE, INC.
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Dates
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Enumeration Date | 08/09/2010
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Last Update Date | 08/09/2010
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Provider Practice Location Address
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Address Line | 525 E 13TH ST
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City | WINAMAC
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State | IN
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Zip | 46996-1144
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Country | US
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Telephone | 574-946-6886
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Fax | 574-946-7342
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Provider Business Mailing Address
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Address Line | PO BOX 186
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City | WINAMAC
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State | IN
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Zip | 46996-0186
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Country | US
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Telephone | 574-946-6886
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Fax | 574-946-7342
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FRANK ALAN UTES
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Credential | D.O.
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Telephone | 574-946-6886
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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 | 02000647
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License Number State | IN
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