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General NPI Number Information
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NPI Number | 1720649957
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Entity Type | Individual
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Provider Name | JONATHAN SINYARD
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Gender | Male
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Dates
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Enumeration Date | 06/27/2019
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Last Update Date | 06/27/2019
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Provider Practice Location Address
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Address Line | 408 E 16TH AVE STE B
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City | CORDELE
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State | GA
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Zip | 31015-1699
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Country | US
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Telephone | 229-273-3433
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 924
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City | CORDELE
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State | GA
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Zip | 31010-0924
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Country | US
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Telephone |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH024901
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License Number State | GA
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