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General NPI Number Information
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NPI Number | 1811170749
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Entity Type | Organization
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Legal Business Name | HAROLD KIM JONES DPM PC
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Dates
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Enumeration Date | 12/13/2007
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Last Update Date | 03/09/2010
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Provider Practice Location Address
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Address Line | 75 N 200 W #1
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City | VERNAL
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State | UT
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Zip | 84078-2001
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Country | US
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Telephone | 435-789-2062
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Fax | 435-789-2063
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Provider Business Mailing Address
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Address Line | 75 N 200 W #1
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City | VERNAL
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State | UT
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Zip | 84078-2001
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Country | US
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Telephone | 435-789-2062
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Fax | 435-789-2063
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Authorized Official
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Title or Position | PC
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Name | HAROLD KIM JONES
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Credential | DPM
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Telephone | 435-789-2062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | 1066250501
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License Number State | UT
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