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General NPI Number Information
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NPI Number | 1033926167
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Entity Type | Organization
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Legal Business Name | MCKENZIE WILLAMETTE REGIONAL MEDICAL CENTER ASSOCIATES LLC
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Dates
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Enumeration Date | 12/12/2024
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 1460 G ST
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City | SPRINGFIELD
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State | OR
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Zip | 97477-4112
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Country | US
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Telephone | 541-726-4401
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Fax |
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Provider Business Mailing Address
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Address Line | 1573 MALLORY LN
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City | BRENTWOOD
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State | TN
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Zip | 37027-2895
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VP PHYSICIAN SERVICES FINANCIAL OPS
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Name | LAURA J FEY
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Credential |
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Telephone | 615-221-3641
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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