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General NPI Number Information
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NPI Number | 1811878044
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Entity Type | Individual
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Provider Name | KAYODE DANIEL AGUDA MD
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Gender | Male
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Dates
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Enumeration Date | 09/12/2025
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Last Update Date | 09/12/2025
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Provider Practice Location Address
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Address Line | 13013 FULLER AVE
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City | GRANDVIEW
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State | MO
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Zip | 64030-2619
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Country | US
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Telephone | 816-214-5548
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Fax |
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Provider Business Mailing Address
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Address Line | 857 SOUTH AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65806-3281
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Country | US
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Telephone | 724-467-1180
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2025035418
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License Number State | MO
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