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General NPI Number Information
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NPI Number | 1831045046
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Entity Type | Individual
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Provider Name | TYJUAN A MCGEE
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Gender | Male
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Dates
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Enumeration Date | 03/09/2026
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Last Update Date | 03/09/2026
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Provider Practice Location Address
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Address Line | 6613 GOLD CT
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City | LITTLE ROCK
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State | AR
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Zip | 72209-8317
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Country | US
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Telephone | 501-235-0909
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Fax |
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Provider Business Mailing Address
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Address Line | 37 BROOKWY LN 37 BROOKWY LN
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City | SHERWOOD
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State | AR
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Zip | 72120
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Country | US
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Telephone | 773-899-2879
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Fax | 773-899-2879
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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 | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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