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General NPI Number Information
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NPI Number | 1730494634
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Entity Type | Organization
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Legal Business Name | LONNIE R. SMITH, M.D., INC
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Dates
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Enumeration Date | 08/16/2010
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Last Update Date | 08/16/2010
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Provider Practice Location Address
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Address Line | 1066 N CHERRY ST
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City | TULARE
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State | CA
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Zip | 93274-2251
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Country | US
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Telephone | 559-686-2599
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Fax | 559-686-5206
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Provider Business Mailing Address
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Address Line | 1066 N CHERRY ST
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City | TULARE
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State | CA
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Zip | 93274-2251
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Country | US
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Telephone | 559-686-2599
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Fax | 559-686-5206
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Authorized Official
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Title or Position | OWNER
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Name | DR. LONNIE RAY SMITH
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Credential | M.D.
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Telephone | 559-686-2599
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G51637
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License Number State | CA
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