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General NPI Number Information
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NPI Number | 1770633182
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Entity Type | Individual
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Provider Name | PABLO ALABANZA MERCED M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/11/2007
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Last Update Date | 01/26/2011
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Provider Practice Location Address
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Address Line | 1389 HIGHWAY 15 N
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City | JACKSON
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State | KY
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Zip | 41339-9404
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Country | US
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Telephone | 606-666-4011
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Fax | 606-666-5801
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Provider Business Mailing Address
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Address Line | PO BOX 606
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City | JACKSON
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State | KY
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Zip | 41339-0606
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Country | US
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Telephone | 606-666-4011
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Fax | 606-666-5801
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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 | KY24420
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License Number State | KY
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