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General NPI Number Information
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NPI Number | 1942167580
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Entity Type | Individual
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Provider Name | TAYLOR J TIPTON
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Gender | Female
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | US AIR FORCE LOCATIONS
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City | APO
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State | AA
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Zip | 39540
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Country | US
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Telephone | 267-273-9962
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Fax |
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Provider Business Mailing Address
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Address Line | 17017 CANARY PALM DR
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City | DIBERVILLE
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State | MS
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Zip | 39540-3825
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Country | US
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Telephone |
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Fax |
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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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 2510756
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License Number State | MD
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