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General NPI Number Information
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NPI Number | 1750191896
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Entity Type | Individual
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Provider Name | REGINALD NOEL
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Gender | Male
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 222 RIVER PARK NORTH DR # A
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City | WOODSTOCK
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State | GA
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Zip | 30188-7834
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Country | US
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Telephone | 470-400-3425
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Fax |
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Provider Business Mailing Address
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Address Line | 181 CAMDYN CIR
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City | WOODSTOCK
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State | GA
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Zip | 30188-2406
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Country | US
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Telephone | 404-931-1031
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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