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General NPI Number Information
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NPI Number | 1720306566
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Entity Type | Organization
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Legal Business Name | MED FUSION, LLC
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Dates
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Enumeration Date | 05/04/2010
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 2501 S STATE HIGHWAY 121 BUS STE 1100
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City | LEWISVILLE
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State | TX
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Zip | 75067-8065
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Country | US
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Telephone | 972-966-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 14275 MIDWAY RD STE 400
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City | ADDISON
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State | TX
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Zip | 75001-3614
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Country | US
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Telephone | 866-697-8378
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Fax |
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Authorized Official
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Title or Position | SR. VICE PRESIDENT
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Name | LEAH D TIMMERMAN
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Credential |
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Telephone | 973-520-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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