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General NPI Number Information
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NPI Number | 1780803460
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Entity Type | Organization
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Legal Business Name | HOPE CLINIC, INC.
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Dates
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Enumeration Date | 04/24/2007
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Last Update Date | 12/01/2020
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Provider Practice Location Address
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Address Line | 121 LANGLEY DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-6930
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Country | US
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Telephone | 770-685-1300
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Fax | 770-685-1311
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Provider Business Mailing Address
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Address Line | PO BOX 1247
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-1247
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Country | US
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Telephone | 770-685-1300
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Fax | 770-685-1311
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. WILLIAM B MARTIN
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Credential | M.D.
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Telephone | 770-685-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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