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General NPI Number Information
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NPI Number | 1528180999
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Entity Type | Individual
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Provider Name | JEREMIAH SCOTT MCWILLIAMS PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1000 E WALNUT LAWN ST
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City | SPRINGFIELD
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State | MO
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Zip | 65807-7313
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Country | US
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Telephone | 417-269-9892
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Fax |
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Provider Business Mailing Address
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Address Line | 3855 S WALNUT HILL AVE
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City | SPRINGFIELD
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State | MO
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Zip | 65807-7413
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Country | US
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Telephone | 417-886-4206
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2003000600
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License Number State | MO
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