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General NPI Number Information
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NPI Number | 1922895218
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Entity Type | Organization
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Legal Business Name | GRAVES GILBERT CLINIC, PLLC
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 05/01/2026
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Provider Practice Location Address
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Address Line | 950 MAIN ST
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City | MUNFORDVILLE
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State | KY
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Zip | 42765-9435
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Country | US
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Telephone | 270-524-1201
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Fax | 270-506-5972
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Provider Business Mailing Address
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Address Line | 201 PARK ST
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1742
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Country | US
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Telephone | 270-781-5111
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Fax | 270-783-3750
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Authorized Official
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Title or Position | DHA, MHA
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Name | MICHAEL E D'ERAMO
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Credential |
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Telephone | 614-499-0667
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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