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General NPI Number Information
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NPI Number | 1265659510
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Entity Type | Individual
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Provider Name | WILLIAM P IRVINE MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2007
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 470 NE A ST
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City | MADRAS
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State | OR
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Zip | 97741-1844
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Country | US
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Telephone | 541-475-4800
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Fax | 541-475-4805
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Provider Business Mailing Address
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Address Line | 600 SW COLUMBIA ST STE 6210
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City | BEND
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State | OR
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Zip | 97702-1099
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Country | US
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Telephone | 541-383-3005
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD28377
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License Number State | OR
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