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General NPI Number Information
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NPI Number | 1801575188
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Entity Type | Individual
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Provider Name | JOSEPH PAUL SMITH PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/14/2023
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Last Update Date | 07/14/2023
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Provider Practice Location Address
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Address Line | 2175 STATE ROAD 4
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City | PINON
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State | AZ
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Zip | 86510
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Country | US
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Telephone | 928-725-9514
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Fax |
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Provider Business Mailing Address
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Address Line | 2695 DELLINGER DR
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City | MARIETTA
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State | GA
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Zip | 30062-4704
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Country | US
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Telephone | 678-756-4003
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 028604
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License Number State | GA
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