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General NPI Number Information
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NPI Number | 1730620246
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Entity Type | Individual
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Provider Name | HANNA FOGG D.O.
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Gender | Female
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Dates
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Enumeration Date | 03/16/2017
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Last Update Date | 09/10/2024
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Provider Practice Location Address
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Address Line | 6126 E 61ST ST
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City | TULSA
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State | OK
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Zip | 74136-2117
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Country | US
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Telephone | 918-576-6998
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Fax | 918-584-8620
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Provider Business Mailing Address
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Address Line | 300 20TH AVE N FL 9
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City | NASHVILLE
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State | TN
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Zip | 37203-5600
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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 | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 4735
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License Number State | TN
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