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General NPI Number Information
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NPI Number | 1003496712
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Entity Type | Individual
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Provider Name | PAUL BRIDGES DO
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Gender | Male
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 08/19/2024
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Provider Practice Location Address
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Address Line | 1925 MOUNTAIN VIEW AVE
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City | LONGMONT
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State | CO
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Zip | 80501-3128
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Country | US
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Telephone | 720-494-3121
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Fax | 720-494-3108
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Provider Business Mailing Address
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Address Line | 1520 N SENATE AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46202-2213
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Country | US
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Telephone | 317-962-0857
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Fax | 317-962-5479
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | DR.0073669
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License Number State | CO
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