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General NPI Number Information
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NPI Number | 1821492513
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Entity Type | Organization
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Legal Business Name | STANSTON D. SPENCE, M.D., P.C.
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Dates
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Enumeration Date | 10/09/2014
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Last Update Date | 10/09/2014
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Provider Practice Location Address
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Address Line | 303 PARKWAY DR NE
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City | ATLANTA
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State | GA
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Zip | 30312-1212
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Country | US
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Telephone | 678-586-3055
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Fax | 678-586-3674
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Provider Business Mailing Address
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Address Line | PO BOX 162728
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City | ATLANTA
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State | GA
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Zip | 30321-2728
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Country | US
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Telephone | 678-586-3055
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Fax | 678-586-3674
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Authorized Official
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Title or Position | OWNER/DR.
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Name | DR. STANSTON D SPENCE
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Credential | M.D.
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Telephone | 678-586-3055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 32474
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License Number State | GA
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