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General NPI Number Information
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NPI Number | 1962002105
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Entity Type | Individual
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Provider Name | STUART N WALKER RPH
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Gender | Male
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 2250 LINCOLN AVE
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City | NEVADA
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State | MO
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Zip | 64772-4258
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Country | US
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Telephone | 417-667-3011
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Fax |
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Provider Business Mailing Address
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Address Line | 404 WHITE OAK DR
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City | EL DORADO SPRINGS
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State | MO
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Zip | 64744-2600
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Country | US
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Telephone | 417-296-0759
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 040888
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License Number State | MO
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