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General NPI Number Information
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NPI Number | 1922169846
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE VASCULAR CARE, LLC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1109 BURLEYSON RD SUITE 202
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City | DALTON
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State | GA
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Zip | 30720-3094
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Country | US
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Telephone | 706-259-3336
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Fax | 706-370-7715
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Provider Business Mailing Address
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Address Line | 1109 BURLEYSON RD SUITE 202
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City | DALTON
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State | GA
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Zip | 30720-3094
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Country | US
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Telephone | 706-259-3336
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Fax | 706-370-7715
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Authorized Official
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Title or Position | OWNER
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Name | IAN NEIL HAMILTON JR.
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Credential | M.D.
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Telephone | 706-259-3336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | 047329
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License Number State | GA
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