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General NPI Number Information
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NPI Number | 1710957485
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Entity Type | Individual
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Provider Name | RUSSELL W BECKER D.O.
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Gender | Male
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 09/22/2020
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Provider Practice Location Address
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Address Line | 1875 VETERANS PARK DR STE 2203
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City | NAPLES
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State | FL
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Zip | 34109-0596
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Country | US
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Telephone | 239-431-5884
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Fax | 239-631-6907
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Provider Business Mailing Address
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Address Line | 1875 VETERANS PARK DR STE 2203
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City | NAPLES
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State | FL
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Zip | 34109-0596
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Country | US
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Telephone | 239-431-5884
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Fax | 239-631-6907
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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 | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | OS12827
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License Number State | FL
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