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General NPI Number Information
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NPI Number | 1942571005
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Entity Type | Organization
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Legal Business Name | INNOVATIVE HEALTHCARE SOLUTIONS LLC
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Dates
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Enumeration Date | 01/21/2012
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Last Update Date | 02/08/2012
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Provider Practice Location Address
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Address Line | 901 12TH AVE S
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City | NASHVILLE
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State | TN
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Zip | 37203-4705
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Country | US
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Telephone | 615-254-1786
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Fax |
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Provider Business Mailing Address
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Address Line | 3016 KINGSTON CIR N
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City | MOUNT JULIET
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State | TN
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Zip | 37122-8441
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Country | US
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Telephone | 615-500-9563
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Fax |
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Authorized Official
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Title or Position | CHAIRMAN
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Name | MR. JOSEPH D CLAYBON
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Credential |
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Telephone | 615-500-9563
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13877
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License Number State | TN
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