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NPI 1881783322

NPI 1881783322 : SCOTT J MEGNA M.D. : SIERRA VISTA, AZ

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General NPI Number Information
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    NPI Number           |    1881783322
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    Entity Type          |    Individual 
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    Provider Name        |    SCOTT J MEGNA M.D.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/12/2006
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    Last Update Date     |    08/27/2014
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Provider Practice Location Address
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    Address Line         |    300 EL CAMINO REAL 
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    City                 |    SIERRA VISTA
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    State                |    AZ
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    Zip                  |    85635-2812
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    Country              |    US
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    Telephone            |    520-885-2231
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    Fax                  |    520-885-2471
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Provider Business Mailing Address
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    Address Line         |    PO BOX 17689 
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    City                 |    TUCSON
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    State                |    AZ
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    Zip                  |    85731-7689
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    Country              |    US
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    Telephone            |    520-885-2231
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    Fax                  |    520-885-2471
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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        |    207P00000X
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    Taxonomy Name        |    Emergency Medicine Physician
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    License Number       |    30800
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    License Number State |    AZ
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