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General NPI Number Information
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NPI Number | 1760577878
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Entity Type | Organization
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Legal Business Name | MARSHALL IMAGING CENTER, LLC
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/11/2008
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Provider Practice Location Address
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Address Line | 11491 US HIGHWAY 431
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City | ALBERTVILLE
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State | AL
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Zip | 35950-0136
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Country | US
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Telephone | 256-894-6950
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11407
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City | BIRMINGHAM
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State | AL
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Zip | 35246-1258
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Country | US
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Telephone | 205-871-4274
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Fax | 205-871-4301
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | KYLENE GOODWIN
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Credential |
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Telephone | 205-868-6209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1200X
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Taxonomy Name | Magnetic Resonance Imaging (MRI) Clinic/Center
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License Number |
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License Number State |
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