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General NPI Number Information
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NPI Number | 1720379498
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Entity Type | Individual
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Provider Name | CASEY L DELCOCO MD
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Gender | Female
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 08/29/2023
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Provider Practice Location Address
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Address Line | 8240 NAAB RD STE 416
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-5927
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Country | US
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Telephone | 317-306-5588
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Fax | 317-550-1544
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Provider Business Mailing Address
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Address Line | 8240 NAAB RD STE 416
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City | INDIANAPOLIS
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State | IN
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Zip | 46260-5927
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Country | US
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Telephone | 317-306-5588
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Fax | 317-550-1544
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 01074227A
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License Number State | IN
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