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General NPI Number Information
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NPI Number | 1043780497
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Entity Type | Individual
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Provider Name | RYAN A WILLIAMS PA-C
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Gender | Male
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Dates
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Enumeration Date | 11/28/2018
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Last Update Date | 02/26/2019
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Provider Practice Location Address
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Address Line | 12605 E 16TH AVE
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City | AURORA
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State | CO
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Zip | 80045-2545
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Country | US
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Telephone | 720-848-0000
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Fax |
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Provider Business Mailing Address
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Address Line | 18904 E PROGRESS AVE
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City | CENTENNIAL
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State | CO
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Zip | 80015-4880
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Country | US
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Telephone | 303-587-6287
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Fax |
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA.0005554
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA.0005554
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License Number State | CO
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