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General NPI Number Information
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NPI Number | 1831219922
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Entity Type | Organization
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Legal Business Name | J. P. FORAGE, M.D., P.A.
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 11645 ANGUS RD STE B-6
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City | AUSTIN
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State | TX
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Zip | 78759-4020
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Country | US
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Telephone | 512-443-5954
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Fax | 512-326-3433
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Provider Business Mailing Address
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Address Line | 11645 ANGUS RD STE B-6
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City | AUSTIN
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State | TX
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Zip | 78759-4020
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Country | US
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Telephone | 512-443-5954
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Fax | 512-326-3433
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Authorized Official
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Title or Position | PRESIDENT
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Name | JEAN-PIERRE FORAGE
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Credential | M.D.
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Telephone | 512-443-5954
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G5050
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License Number State | TX
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