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General NPI Number Information
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NPI Number | 1851165229
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Entity Type | Organization
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Legal Business Name | KMEDEX INC
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Dates
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Enumeration Date | 11/07/2023
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Last Update Date | 11/07/2023
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Provider Practice Location Address
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Address Line | 330 MONTROSE DR
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City | FOLSOM
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State | CA
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Zip | 95630-2720
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Country | US
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Telephone | 916-741-7333
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Fax |
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Provider Business Mailing Address
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Address Line | 2522 R ST
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City | SACRAMENTO
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State | CA
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Zip | 95816-6955
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Country | US
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Telephone | 916-741-7333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KEVIN JEFFREY MITCHELL
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Credential | MD
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Telephone | 916-741-7333
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number |
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License Number State |
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