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General NPI Number Information
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NPI Number | 1043432719
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Entity Type | Individual
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Provider Name | WILLIAM LAFAYETTE BETSILL M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 12/19/2022
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Provider Practice Location Address
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Address Line | 6240 SHILOH RD
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City | ALPHARETTA
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State | GA
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Zip | 30005-8347
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Country | US
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Telephone | 855-422-5628
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Fax | 205-579-9387
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Provider Business Mailing Address
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Address Line | 6240 SHILOH RD
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City | ALPHARETTA
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State | GA
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Zip | 30005-8347
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Country | US
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Telephone |
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Fax | 205-579-9387
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 33598
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License Number State | KY
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