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General NPI Number Information
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NPI Number | 1841230257
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Entity Type | Individual
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Provider Name | SCOTT E PATRICK M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1112 W 6TH ST SUITE 110
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City | LAWRENCE
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State | KS
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Zip | 66044-2215
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Country | US
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Telephone | 784-841-3211
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Fax |
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Provider Business Mailing Address
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Address Line | 4520 CEDAR RIDGE CT
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City | LAWRENCE
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State | KS
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Zip | 66049-3802
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Country | US
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Telephone | 784-841-3211
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 0428372
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License Number State | KS
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