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General NPI Number Information
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NPI Number | 1154863249
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Entity Type | Individual
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Provider Name | ZACHARY A HITCHCOCK PA
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Gender | Male
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Dates
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Enumeration Date | 11/07/2016
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1107 S LEMAY AVE STE 240
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City | FORT COLLINS
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State | CO
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Zip | 80524-3959
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Country | US
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Telephone | 970-495-7421
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Fax | 970-495-7424
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Provider Business Mailing Address
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Address Line | 4674 SNOW MESA DR SUITE 140
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City | FORT COLLINS
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State | CO
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Zip | 80528-8615
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Country | US
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Telephone | 970-225-5000
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Fax | 970-482-9646
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA0004787
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License Number State | CO
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