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General NPI Number Information
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NPI Number | 1902261274
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Entity Type | Organization
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Legal Business Name | COMPLETE HEALTH MEDICAL CENTER
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Dates
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Enumeration Date | 12/30/2015
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Last Update Date | 12/30/2015
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Provider Practice Location Address
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Address Line | 4153 FLAT SHOALS PKWY BLDG A STE 104
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City | DECATUR
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State | GA
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Zip | 30034-4106
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Country | US
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Telephone | 404-241-7062
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Fax | 404-243-0357
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Provider Business Mailing Address
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Address Line | 11770 HAYNES BRIDGE RD STE 205-215
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City | ALPHARETTA
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State | GA
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Zip | 30009-1966
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Country | US
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Telephone | 404-241-7062
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Fax | 404-243-0357
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Authorized Official
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Title or Position | OWNER
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Name | DR. VICTOR Y LESLIE
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Credential | MD
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Telephone | 404-241-7062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | 074690
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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