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General NPI Number Information
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NPI Number | 1710337365
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Entity Type | Individual
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Provider Name | DR. JOSHUA HOUSTON
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Gender | Male
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 03/13/2018
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Provider Practice Location Address
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Address Line | 1030 VETERANS PKWY
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City | CLARKSVILLE
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State | IN
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Zip | 47129-2354
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Country | US
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Telephone | 812-282-2020
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Fax |
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Provider Business Mailing Address
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Address Line | 15107 ABINGTON RIDGE PL
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City | LOUISVILLE
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State | KY
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Zip | 40245-5269
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Country | US
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Telephone | 740-396-0528
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Fax |
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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 | 18003969A
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License Number State | IN
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