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General NPI Number Information
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NPI Number | 1982709937
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Entity Type | Individual
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Provider Name | SAMUEL P ROBISON OD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3180 S 5600 W
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City | WEST VALLEY CITY
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State | UT
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Zip | 84120-1300
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Country | US
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Telephone | 801-966-8495
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Fax | 801-966-8497
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Provider Business Mailing Address
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Address Line | 3180 S 5600 W
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City | WEST VALLEY CITY
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State | UT
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Zip | 84120-1300
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Country | US
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Telephone | 801-966-8495
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Fax | 801-966-8497
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 107756-9934
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License Number State | UT
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