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General NPI Number Information
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NPI Number | 1770535965
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Entity Type | Individual
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Provider Name | JAMES J ALTENBERND O.D.
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Gender | Male
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 03/20/2008
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Provider Practice Location Address
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Address Line | 4512 LEMAY FERRY RD
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City | SAINT LOUIS
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State | MO
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Zip | 63129-1614
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Country | US
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Telephone | 314-845-6410
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Fax |
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Provider Business Mailing Address
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Address Line | 3549 YAEGER CROSSING CT
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City | SAINT LOUIS
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State | MO
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Zip | 63129-2369
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Country | US
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Telephone | 314-487-8651
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | DO2917
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License Number State | MO
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