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General NPI Number Information
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NPI Number | 1770687923
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Entity Type | Individual
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Provider Name | JANE L GILMORE M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/09/2006
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Last Update Date | 02/13/2018
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Provider Practice Location Address
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Address Line | 1365 CLIFTON RD NE 3RD FLOOR
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City | ATLANTA
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State | GA
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Zip | 30322-1013
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Country | US
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Telephone | 404-778-3444
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Fax |
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Provider Business Mailing Address
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Address Line | 121 RUSSELL ST
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City | DECATUR
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State | GA
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Zip | 30030-4843
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 040077
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 040077
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License Number State | GA
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