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General NPI Number Information
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NPI Number | 1265765226
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Entity Type | Organization
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Legal Business Name | WILLIAM S. MAXFIELD, M.D., LLC
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 09/09/2009
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Provider Practice Location Address
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Address Line | 8947 DONNA LU DR
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City | ODESSA
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State | FL
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Zip | 33556-1908
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Country | US
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Telephone | 813-857-3864
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Fax | 813-920-1755
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Provider Business Mailing Address
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Address Line | 8947 DONNA LU DR
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City | ODESSA
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State | FL
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Zip | 33556-1908
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Country | US
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Telephone | 813-857-3864
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Fax | 813-920-1755
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | WILLIAM S. MAXFIELD
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Credential | M.D.
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Telephone | 813-857-3864
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME15266
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License Number State | FL
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