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NPI 1902813314

NPI 1902813314 : KRISTIN E CHRISTIAN OD : EL DORADO, AR

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General NPI Number Information
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    NPI Number           |    1902813314
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    Entity Type          |    Individual 
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    Provider Name        |    KRISTIN E CHRISTIAN OD
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    08/01/2006
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    Last Update Date     |    11/09/2023
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Provider Practice Location Address
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    Address Line         |    300 THOMPSON AVE 
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    City                 |    EL DORADO
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    State                |    AR
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    Zip                  |    71730-4569
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    Country              |    US
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    Telephone            |    870-862-2340
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    Fax                  |    870-862-2548
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Provider Business Mailing Address
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    Address Line         |    300 THOMPSON AVE 
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    City                 |    EL DORADO
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    State                |    AR
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    Zip                  |    71730-4569
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    Country              |    US
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    Telephone            |    870-862-2340
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    Fax                  |    870-862-2548
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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        |    152W00000X
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    Taxonomy Name        |    Optometrist
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    License Number       |    2574
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    License Number State |    AR
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