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General NPI Number Information
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NPI Number | 1942395686
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Entity Type | Individual
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Provider Name | KERRY G ENGELKING M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 10240 W POISON SPIDER RD
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City | CASPER
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State | WY
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Zip | 82604-9556
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Country | US
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Telephone | 307-277-5502
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Fax |
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Provider Business Mailing Address
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Address Line | 111 W 2ND ST SUITE 415
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City | CASPER
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State | WY
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Zip | 82601-2454
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Country | US
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Telephone | 307-237-5848
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Fax | 307-237-5848
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 3569A
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License Number State | WY
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