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General NPI Number Information
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NPI Number | 1780879015
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Entity Type | Organization
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Legal Business Name | JOSE E MERCED MD LLC
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Dates
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Enumeration Date | 09/10/2007
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 433 LA NEUVILLE RD
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City | YOUNGSVILLE
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State | LA
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Zip | 70592-5212
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Country | US
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Telephone | 337-769-3002
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Fax | 337-769-0309
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Provider Business Mailing Address
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Address Line | PO BOX 81023
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City | LAFAYETTE
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State | LA
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Zip | 70598-1023
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Country | US
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Telephone | 337-769-3002
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Fax | 337-769-0309
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSE EDGARDO MERCED
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Credential | M.D.
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Telephone | 337-769-3002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 021815
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License Number State | LA
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