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General NPI Number Information
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NPI Number | 1881851582
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Entity Type | Organization
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Legal Business Name | HOME PHYSICIANS SERVICES, LLC
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Dates
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Enumeration Date | 05/20/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 7330 FERN AVE SUITE 402
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City | SHREVEPORT
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State | LA
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Zip | 71105-4971
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Country | US
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Telephone | 318-221-2535
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 180
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City | SHREVEPORT
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State | LA
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Zip | 71161-0180
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Country | US
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Telephone | 318-221-2535
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Fax |
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DEBORAH FLETCHER
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Credential | M.D.
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Telephone | 318-221-2535
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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 | 022250
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License Number State | LA
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