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General NPI Number Information
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NPI Number | 1881844926
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Entity Type | Organization
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Legal Business Name | CADIZ FAMILY CARE CLINIC, LLC
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Dates
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Enumeration Date | 09/25/2008
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 261 MAIN ST
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City | CADIZ
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State | KY
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Zip | 42211-6125
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Country | US
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Telephone | 270-522-9697
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Fax | 270-522-9698
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Provider Business Mailing Address
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Address Line | 261 MAIN ST
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City | CADIZ
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State | KY
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Zip | 42211-6125
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Country | US
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Telephone | 270-522-9697
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Fax | 270-522-9698
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | DR. CATHERINE R. GALLA
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Credential | M.D.
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Telephone | 270-522-9696
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 31208
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License Number State | KY
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