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General NPI Number Information
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NPI Number | 1750878948
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Entity Type | Individual
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Provider Name | JAMES DONALD SMITH
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Gender | Male
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 580 RICE ST
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City | SAINT PAUL
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State | MN
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Zip | 55103-2148
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Country | US
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Telephone | 651-227-6551
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Fax |
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Provider Business Mailing Address
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Address Line | 1700 UNIVERSITY AVE W
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City | SAINT PAUL
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State | MN
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Zip | 55104-3727
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 66008
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 66008
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License Number State | MN
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