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General NPI Number Information
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NPI Number | 1942757547
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Entity Type | Organization
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Legal Business Name | MAGEE SPINAL REHAB CENTER, LLC
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Dates
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Enumeration Date | 09/01/2016
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Last Update Date | 09/01/2016
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Provider Practice Location Address
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Address Line | 1383 HIGHWAY 51 NE
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City | BROOKHAVEN
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State | MS
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Zip | 39601-8651
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Country | US
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Telephone | 601-835-1800
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Fax |
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Provider Business Mailing Address
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Address Line | 1383 HWY 51 NE
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City | BROOKHAVEN
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State | MS
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Zip | 39601-8651
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Country | US
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Telephone | 601-835-1800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSEPH DELANE MAGEE
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Credential | D.C.
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Telephone | 678-462-5628
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 1226
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License Number State | MS
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