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General NPI Number Information
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NPI Number | 1972792885
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Entity Type | Organization
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Legal Business Name | EMORY HEALTHCARE
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 1365 CLIFTON RD NE SUITE A2200
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City | ATLANTA
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State | GA
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Zip | 30322-1013
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Country | US
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Telephone | 954-319-9792
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Fax |
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Provider Business Mailing Address
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Address Line | 5748 LITTLE OAK TRL
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City | STONE MOUNTAIN
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State | GA
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Zip | 30087-2977
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Country | US
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Telephone | 770-806-3994
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Fax |
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Authorized Official
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Title or Position | CLINICAL DIRECTOR, CT SURGERY
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Name | MR. KEITH CAUSEY
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Credential | PA-C
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Telephone | 404-395-4355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 005186
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License Number State | GA
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