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NPI 1164446076

NPI 1164446076 : JEREMY K LAW MD : THORNTON, CO

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General NPI Number Information
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    NPI Number           |    1164446076
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    Entity Type          |    Individual 
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    Provider Name        |    JEREMY K LAW MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    07/26/2006
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    Last Update Date     |    03/18/2008
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Provider Practice Location Address
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    Address Line         |    9351 GRANT ST SUITE 360
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    City                 |    THORNTON
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    State                |    CO
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    Zip                  |    80229
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    Country              |    US
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    Telephone            |    303-423-2000
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    Fax                  |    303-420-2520
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Provider Business Mailing Address
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    Address Line         |    9351 GRANT ST #360
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    City                 |    THORNTON
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    State                |    CO
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    Zip                  |    80229
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    Country              |    US
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    Telephone            |    303-423-2000
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    Fax                  |    303-420-2520
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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        |    174400000X
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    Taxonomy Name        |    Specialist
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    License Number       |    32505
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    License Number State |    CO
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