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General NPI Number Information
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NPI Number | 1942587159
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Entity Type | Organization
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Legal Business Name | AULT MCINNIS PLLC
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Dates
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Enumeration Date | 11/16/2011
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Last Update Date | 05/13/2025
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Provider Practice Location Address
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Address Line | 2114 E RUSK ST
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City | JACKSONVILLE
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State | TX
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Zip | 75766-9052
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Country | US
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Telephone | 903-284-6105
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Fax | 903-284-6104
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Provider Business Mailing Address
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Address Line | 2116 E RUSK ST
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City | JACKSONVILLE
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State | TX
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Zip | 75766-9052
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Country | US
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Telephone | 903-284-6105
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Fax | 903-284-6104
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Authorized Official
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Title or Position | OWNER
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Name | DR. KRISTIN LEE AULT
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Credential | DO
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Telephone | 903-284-6105
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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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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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